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Parenteral nutrition in prematures

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https://www.readbyqxmd.com/read/28079870/impact-of-l-carnitine-supplementation-on-metabolic-profiles-in-premature-infants
#1
R H Clark, D H Chace, A R Spitzer
OBJECTIVE: To describe the influence that of l-carnitine supplementation on acylcarnitine (AC) profiles and hospital outcomes in premature infants. STUDY DESIGN: This study is a secondary analysis of previously reported work. Metabolic profiles were obtained using standard newborn techniques on infants born between 23 and 31 completed weeks of gestation. The profiles were drawn within the first 24 h after birth and on approximately days 7, 28 and 42 of life, or at the time of discharge...
January 12, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28045772/nutritional-practices-and-growth-in-premature-infants-after-surgical-necrotizing-enterocolitis
#2
Grace C Lin, Daniel T Robinson, Steven Olsen, Kristina M Reber, Mohannad Moallem, Robert DiGeronimo, Cecilia Mulroy, Ankur Datta, Karna Murthy
OBJECTIVE: To describe the nutritional provisions received by infants with surgical NEC and the associated effects on short-term growth. STUDY DESIGN: Through the Children's Hospitals Neonatal Database we identified infants born ≤32 weeks' gestation with surgical NEC from 5 regional neonatal intensive care units over 4 years. Excluded infants had isolated intestinal perforation and died <14 days post-operatively. Infants were stratified by their median parenteral protein dose (low (LP) or high (HP) protein) over the first post-operative week...
December 30, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/28033194/neonatal-soft-tissue-reconstruction-using-a-bioengineered-skin-substitute
#3
Scott D Hirsch, Jeremy M Powers, Jennifer L Rhodes
Total parenteral nutrition (TPN) can be a lifesaving intervention for premature neonates and it is often delivered through peripheral access in this unique population. However, extravasation and tissue damage can result. Current literature lacks strong evidence regarding the treatment and reconstruction of such injuries in this age group. The authors present a patient with a 30-week gestational age premature newborn whom suffered an extravasation injury with peripherally administered TPN leading to full thickness skin and soft tissue necrosis of the dorsum of the right hand...
December 28, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28028560/pathophysiology-prevention-treatment-and-outcomes-of-intestinal-failure-associated-liver-disease
#4
REVIEW
Noora H Al-Shahwani, David L Sigalet
BACKGROUND: Intestinal failure-associated liver disease (IFALD) remains a serious problem in the treatment of infants with nutritional problems and short bowel syndrome. METHODS: A review of the recent literature from 2010 to 2016, concentrating on articles related to the pathophysiology of IFALD and to outcomes of novel nutritional and pharmacological therapies for neonatal cholestasis in the post-surgical neonate. RESULTS: The pathophysiology of IFALD relates to an increase sensitivity of the neonatal liver to cholestasis in the non-fed state; prolonged cholestasis almost inevitably results in liver damage which will progress from fibrosis to cirrhosis...
December 27, 2016: Pediatric Surgery International
https://www.readbyqxmd.com/read/28012639/-guidelines-for-multivitamin-administration-in-fortified-human-milk-prepared-for-preterm-infants
#5
V Rigourd, I Dridi Brahim, S Smii, H Razafimahefa, F Quetin, E Leroy, C Pichon, A Giuseppi, L Berthier, B Pommeret, R Serreau
BACKGROUND: To reach nutritional standards, human milk has to have 2g/dL of protein. In 2013, Lafeber stated that when human milk is fortified up to 2g/dL, it may increase its osmolality up to 500 mOsm/kg. He also warned that care must be taken when adding a drug or vitamins to human milk. AIM: We studied, for the first time, the impact of adding multivitamins (ADEC) on human fortified milk osmolality. METHOD: The osmolality of 36 pasteurized, fortified human milk samples was measured...
December 21, 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27973552/effect-of-early-expressed-human-milk-on-insulin-like-growth-factor-1-and-short-term-outcomes-in-preterm-infants
#6
Francesca Serrao, Patrizia Papacci, Simonetta Costa, Carmen Giannantonio, Francesco Cota, Giovanni Vento, Costantino Romagnoli
AIMS: Preterm breast milk contains high levels of bioactive components, including insulin-like growth factor 1 (IGF-1), that are reduced by Holder pasteurization. Animal studies have shown that milk-borne IGF-1 is likely absorbed intact in a bioactive form by the intestines. The aim of this study was to assess if early non-pasteurized expressed breast milk nutrition may affect IGF-1 plasma levels in premature infants. We also investigated the possible association between early expressed milk nutrition and short-term outcomes...
2016: PloS One
https://www.readbyqxmd.com/read/27872824/packed-red-blood-cell-transfusions-as-a-risk-factor-for-parenteral-nutrition-associated-liver-disease-in-premature-infants
#7
Antoni D'Souza, Anushree Algotar, Ling Pan, Steven M Schwarz, William R Treem, Gloria Valencia, Simon S Rabinowitz
AIM: To determine if packed red blood cell transfusions contribute to the development of parenteral nutrition associated liver disease. METHODS: A retrospective chart review of 49 premature infants on parenteral nutrition for > 30 d who received packed red blood cell (PRBC) transfusions was performed. Parenteral nutrition associated liver disease was primarily defined by direct bilirubin (db) > 2.0 mg/dL. A high transfusion cohort was defined as receiving > 75 mL packed red blood cells (the median value)...
November 8, 2016: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/27845942/outcome-differences-between-simple-and-complex-gastroschisis
#8
Vesna Milojkovic Marinovic, Maija Lukac, Zeljko Mikovic, Blagoje Grujic, Maja Milickovic, Gordana Samardzija, Aleksandra Stojanovic, Dalibor Sabbagh
BACKGROUND: We reviewed differences of the outcome of newborn with simple and complex gastroschisis treated at our institution over the past fifteen years. METHODS: A retrospective cohort study was performed on all infants with gastroschisis treated at the Institute for mother and child health care, Belgrade, between 2001 and 2015 (n=70). Premature infants (<34 weeks of gestation) and babies with birth weight less than 1500 g were excluded (n=5). We compared outcomes in infants with simple gastroschisis and those with complex gastroschisis...
October 14, 2016: Annali Italiani di Chirurgia
https://www.readbyqxmd.com/read/27842958/mortality-related-factors-in-gastroschisis-a-jamaican-perspective
#9
Sarah G Marshall Niles, Kathryn Mitchell-Fearon, Mitchell I Gill, Claudine J DeSouza, Ian C Fearon, Colin A Abel, Brian A James, Noel J McLennon
OBJECTIVE: To determine the mortality rate of patients treated with gastroschisis at a Jamaican pediatric hospital, and to identify factors that contribute significantly to mortality. METHODS: Eighty-five patients were treated with gastroschisis between November 1, 2006 and November 30, 2015. Of these, 80 records were recovered and reviewed retrospectively. Records were analyzed for maternal and patient characteristics, and details of the clinical course. Death during admission was the primary outcome measure...
October 30, 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27836286/acylcarnitine-profiles-reflect-metabolic-vulnerability-for-necrotizing-enterocolitis-in-newborns-born-premature
#10
Karl G Sylvester, Zachary J Kastenberg, R Larry Moss, Gregory M Enns, Tina M Cowan, Gary M Shaw, David K Stevenson, Tiffany J Sinclair, Curt Scharfe, Kelli K Ryckman, Laura L Jelliffe-Pawlowski
OBJECTIVE: To evaluate the association between newborn acylcarnitine profiles and the subsequent development of necrotizing enterocolitis (NEC) with the use of routinely collected newborn screening data in infants born preterm. STUDY DESIGN: A retrospective cohort study was conducted with the use of discharge records for infants born preterm admitted to neonatal intensive care units in California from 2005 to 2009 who had linked state newborn screening results. A model-development cohort of 94 110 preterm births from 2005 to 2008 was used to develop a risk-stratification model that was then applied to a validation cohort of 22 992 births from 2009...
November 8, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27780689/bone-mineral-density-according-to-dual-energy-x-ray-absorptiometry-is-associated-with-serial-serum-alkaline-phosphatase-level-in-extremely-low-birth-weight-infants-at-discharge
#11
Jin Lee, Hyun-Kyung Park, Ja Hye Kim, Yun Young Choi, Hyun Ju Lee
BACKGROUND: To examine bone mineral density in extremely low birth weight infants at discharge and investigate whether serial measurements of serum alkaline phosphatase (ALP) and phosphate can predict bone mineralization. METHODS: The individuals were 70 preterm infants. Serum calcium, phosphate, and ALP were measured at weekly intervals during admission in extremely low birth weight infants (mean gestational age, 25.3±2.1 weeks; birth weight, 812.8±141.1 g)...
September 30, 2016: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/27670958/beneficial-effects-of-mucous-fistula-refeeding-in-necrotizing-enterocolitis-neonates-with-enterostomies
#12
Eugene C T Lau, Adrian C H Fung, Kenneth K Y Wong, Paul K H Tam
BACKGROUND: Necrotizing enterocolitis in premature neonates often results in bowel resection and stoma formation. One way to promote bowel adaptation before stoma closure is to introduce proximal loop effluents into the mucous fistula. In this study, we reviewed our experience with distal loop refeeding with respect to control group. METHODS: All patients with necrotizing enterocolitis between 2000 and 2014 necessitating initial diverting enterostomies and subsequent stoma closure in a tertiary referral center were included...
December 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27621005/nonoperative-management-of-esophageal-perforations-in-the-newborn
#13
Ekene A Onwuka, Payam Saadai, Laura A Boomer, Benedict C Nwomeh
BACKGROUND: Esophageal perforation in neonates occurs most often in cases of extreme prematurity and is commonly due to iatrogenic causes. Treatment over recent decades has become more conservative. The purpose of this study was to review cases of esophageal perforation in neonates and to describe the presentation, management, and outcomes. MATERIALS AND METHODS: A retrospective chart review was performed for patients with International Classification of Diseases, Ninth Revision code for esophageal perforation treated at our institution between the years 2009 and 2015...
September 2016: Journal of Surgical Research
https://www.readbyqxmd.com/read/27614807/mucous-fistula-refeeding-decreases-parenteral-nutrition-exposure-in-postsurgical-premature-neonates
#14
Colin D Gause, Madoka Hayashi, Courtney Haney, Daniel Rhee, Omar Karim, Brian W Weir, Dylan Stewart, Jeffrey Lukish, Henry Lau, Fizan Abdullah, Estelle Gauda, Howard I Pryor
BACKGROUND/PURPOSE: Premature neonates can develop intraabdominal conditions requiring emergent bowel resection and enterostomy. Parenteral nutrition (PN) is often required, but results in cholestasis. Mucous fistula refeeding allows for functional restoration of continuity. We sought to determine the effect of refeeding on nutrition intake, PN dependence, and PN associated hepatotoxicity while evaluating the safety of this practice. METHODS: A retrospective review of neonates who underwent bowel resection and small bowel enterostomy with or without mucous fistula over 2years was undertaken...
November 2016: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/27599697/fatty-acid-requirements-for-the-preterm-infant
#15
REVIEW
Daniel T Robinson, Camilia R Martin
Fatty acids are critical nutrient regulators of intracellular signaling and influence key pathways including inflammatory responses, hemostasis as well as central nervous system development and function. Preterm birth interrupts the maternal-fetal transfer of essential fatty acids including docosahexaenoic and arachidonic acids, which occurs during the third trimester. Postnatal deficits of these nutrients accrue in preterm infants during the first week and they remain throughout the first months. Due to the regulatory roles of these fatty acids, such deficits contribute an increased risk of developing prematurity-related morbidities including impaired growth and neurodevelopment...
September 2, 2016: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27583439/total-antioxidant-total-oxidant-and-serum-paraoxonase-levels-according-to-lipid-administration-method-in-parenterally-fed-premature-infants
#16
Murat Konak, Nuriye Tarakci, Hüseyin Altunhan, Ali Annagür, Aysun Toker, Rahmi Örs
OBJECTIVE: The aim of our study was to determine whether lipid solutions delivered separately or in mixture with total parenteral nutrition (TPN) solutions effect the balance between oxidant and antioxidant levels in premature infants. METHODS: A total of 60 preterm newborns who were delivered at their 30-34 gestational weeks and received TPN were included in the study. Premature newborns were randomized into two groups based on the delivery method of the lipid solution, separately (Group 1) or in mixture with TPN solutions (Group 2)...
September 1, 2016: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/27578120/influence-of-gestational-age-and-birth-weight-in%C3%A2-neonatal-cholesterol-response-to-total-parenteral-nutrition
#17
T Hang Nghiem-Rao, Allison F Dahlgren, Deepti Kalluri, Yumei Cao, Pippa M Simpson, Shailendra B Patel
BACKGROUND: Premature and critically ill infants receiving total parenteral nutrition (TPN) are at risk for dyslipidemia, and altered cholesterol levels in early life may contribute to later cardiovascular risk. Data regarding plasma cholesterol response to TPN in young infants are lacking. OBJECTIVE: To determine the changes in plasma cholesterol levels during the first week of life in infants receiving TPN and a comparison group of infants who did not receive TPN during routine care...
July 2016: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/27574883/favorable-outcomes-of-preterm-infants-with-pnald-treated-with-iv-fish-oil-based-lipid-emulsion
#18
Michael Sorrell, Alvaro Moreira, Kay Green, Rachel Jacobs, Robin Tragus, Laura Keller, Amy Quinn, Donald McCurnin, Alice Gong, Abeer El Sakka, Naveen Mittal, Cynthia Blanco
OBJECTIVES: To study the acute and long-term outcomes of preterm infants treated with an intravenous (IV) fish oil-based lipid emulsion (FishLE) for parenteral nutrition-associated liver disease (PNALD). METHODS: Preterm infants 14 days to 24 months of age with anatomic short gut or severe intestinal dysmotility, serum direct bilirubin ≥4 mg/dL, and requiring >60% calories from PN were eligible. Enrolled infants received 1 g/kg/day of FishLE until resolution of direct hyperbilirubinemia or return of enteral nutrition...
August 27, 2016: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/27540237/medication-management-of-the-extremely-premature-neonate-the-impact-of-a-specialist-pharmacist
#19
Karen Whitfield, Claudia Barkeij, Angela North
AIM: To present a case of an extremely premature infant and the role that the specialist neonatal pharmacist has on the quality of care of these patients. METHOD: Interventions and recommendations made by the pharmacists over the admission of a triplet born at 23 weeks and 5 days gestation were recorded. The type of interventions were categorised and classified for risk using a consequence/probability matrix.1 RESULTS: The patient required admission to the intensive care unit and subsequently the special care unit for a period of 163 days before discharge home...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27504517/nutrition-in-the-preterm-infant-what%C3%A2-s-new
#20
REVIEW
Jemma S Cleminson, Stefan P Zalewski, Nicholas D Embleton
PURPOSE OF REVIEW: The increasing recognition of the role of nutritional care for preterm infants continues to result in a proliferation of review articles, systematic reviews, observational studies and trials. In this article, we review a selection of important studies published in the last 12–18 months. RECENT FINDINGS: The selected studies demonstrate the potential importance of light protecting parenteral nutrition solutions, the benefits of standardized concentrated parenteral nutrition solutions and the importance of insulin-like growth factor I in early life...
May 2016: Current Opinion in Clinical Nutrition and Metabolic Care
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