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Parental nutrition in sick low-birth-weight neonates
Insights
Total Parenteral Nutrition (TPN), including fat, is essential for premature low-birth-weight neonates to achieve optimal weight gain. This method is safe and effective for both healthy and critically ill infants unable to feed orally.
Area of Science:
- Neonatal Nutrition
- Parenteral Nutrition
- Pediatric Gastroenterology
Background:
- Premature low-birth-weight neonates often struggle with oral feeding.
- Nutritional support is critical for growth and development in this vulnerable population.
- Previous methods like amino acids and glucose (A-G) may not provide adequate nutrition.
Purpose of the Study:
- To evaluate the efficacy of Total Parenteral Nutrition (TPN) with amino acids, glucose, and fat versus amino acids and glucose alone in premature low-birth-weight neonates.
- To assess the impact of fat inclusion in TPN on weight gain.
- To determine the safety and tolerability of TPN in sick low-birth-weight neonates.
Main Methods:
- 49 premature low-birth-weight neonates were divided into four groups.
- Groups A and B (healthy neonates) received TPN or A-G respectively.
- Groups C and D (critically ill neonates) received TPN or A-G respectively, via peripheral veins for 7-42 days.
Main Results:
- Neonates receiving TPN (including fat) showed significantly higher weight gain compared to those receiving only A-G.
- The addition of fat to TPN was crucial for achieving intrauterine-like weight gain.
- Sick neonates tolerated TPN well, with fat being essential due to their inability to tolerate high glucose doses.
Conclusions:
- Total Parenteral Nutrition (TPN) with fat is necessary for adequate weight gain in premature low-birth-weight neonates.
- TPN is a safe and effective nutritional strategy for both healthy and critically ill neonates unable to feed orally.
- Fat inclusion in TPN is vital for sick neonates who cannot tolerate high glucose loads.
Abstract:
T. P. N. (aminoacids-glucose-fat) or aminoacids and glucose (A-G.) was given to 49 premature low-birth-weight neonates through peripheral veins for 7--42 days. The T. P. N. infusate contained glucose 12--20.5 g/kg/day and a standard dose of 2 g/kg/day for aminoacids and fat. The patients formed 4 groups: Twenty neonates were healthy but unable to tolerate oral feeding. Ten of them (group A) received T. P. N. and ten (Group B) received only A-G. Twenty nine neonates suffered from serious illness: 14 of them (Group C) received T. P. N. and 15 (Group D) A-G. In healthy neonates the weight gain was significantly higher in those who received T. P. N. than in those who took the same amount of calories but with A-G only. The addition of fat in parenteral nutrition is necessary in order to achieve a weight gain similar to that of intrauterine period. Fat is even more necessary in sick low-birth-weight neonates because they were found to be unable to tolerate high doses of glucose. Only part of the energy intake of the sick neonates could be covered with A-G. The present study has shown that parenteral nutrition can safely be given to sick low-birth-weight neonates without serious complications.