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Parenteral nutrition in prematures

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https://www.readbyqxmd.com/read/29689751/effect-of-standardized-feeding-protocol-on-nutrient-supply-and-postnatal-growth-of-preterm-infants-a-prospective-study
#1
Z Khan, N Morris, H Unterrainer, N Haiden, S J Holasek, B Urlesberger
BACKGROUND: Preterm birth is a medical emergency and it is becoming evident that adequate nutrition starting in the first hours of life is of major importance for short and even more so for long-term health outcomes of the premature newborn. The aim was to analyze postnatal nutrient supply and growth patterns of preterm infants in response to a standardized feeding protocol during stay at neonatal intensive care unit (NICU). METHODS: A prospective cohort study was conducted at NICU, Children Hospital Graz...
2018: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/29666098/a-misplaced-peripherally-inserted-central-catheter-presenting-as-contralateral-pleural-effusion
#2
Jogender Kumar, Sudeep K C, Kanya Mukhopadhyay, Somosri Ray
A preterm neonate born at 27 weeks, with a birth weight of 555 g, was on continuous positive airway pressure (CPAP) for apnoea of prematurity and initially received total parenteral nutrition (TPN) through the umbilical venous catheter. Peripherally inserted central catheter (PICC) was inserted in the left basilica vein on day 8 to continue TPN. The baby developed respiratory distress with persistent hypoxia after TPN was initiated through the PICC line. The baby required mechanical ventilation due to worsening of respiratory distress, and chest X-ray, as well as ultrasound conducted 12 hours, postinfusion of TPN revealed right-sided pleural effusion...
April 17, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29664498/-hypophosphatemia-in-preterm-infants-a-bimodal-disorder
#3
María Paz Cubillos Celis, Patricia Mena Nannig
New nutritional approaches to treat extreme premature babies have demonstrated relevant eviden ce of metabolic disturbances with early hypophosphatemia, especially in patients with intrauterine growth restriction (IUGR). They have shown late hypophosphatemia, as well, which is characteristic in the metabolic bone disease. A sytematic search of literature describing metabolic disturbances of phosphorus in preterm newborns is presented, related to the use of early parenteral nutrition and also in the context of metabolic bone disease...
February 2018: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/29605266/gastrointestinal-mucosal-development-and-injury-in-premature-lambs-supported-by-the-artificial-placenta
#4
Jennifer S McLeod, Joseph T Church, Prathusha Yerramilli, Megan A Coughlin, Elena M Perkins, Raja Rabah, Robert H Bartlett, Alvaro Rojas-Pena, Joel K Greenson, Erin E Perrone, George B Mychaliska
BACKGROUND: An Artificial Placenta (AP) utilizing extracorporeal life support (ECLS) could revolutionize care of extremely premature newborns, but its effects on gastrointestinal morphology and injury need investigation. METHODS: Lambs (116-121days GA, term=145; n=5) were delivered by C-section, cannulated for ECLS, had total parenteral nutrition (TPN) provided, and were supported for 7days before euthanasia. Early and Late Tissue Controls (ETC, n=5 and LTC, n=5) delivered at 115-121days and 125-131days, respectively, were immediately sacrificed...
March 8, 2018: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29603412/improving-nutrition-outcomes-for-infants-1500-grams-with-a-progressive-evidenced-based-enteral-feeding-protocol
#5
Melissa K Thoene, Elizabeth Lyden, Ann Anderson-Berry
BACKGROUND: Growth is essential for very low birth weight infants. The purpose of this retrospective chart review was to evaluate the impact of a new standardized, evidenced-based feeding protocol for infants born < 1500 g in correlation with growth and clinical outcomes. METHODS: Growth and nutrition data was reviewed from 2 groups of infants born < 1500 g within a level III newborn intensive care unit (NICU). Epoch 1 infants (N = 32) received care following initial implementation of a standardized enteral feeding protocol...
March 30, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29594085/stress-signals-during-sucking-activity-are-associated-with-longer-transition-time-to-full-oral-feeding-in-premature-infants
#6
You Gyoung Yi, Byung-Mo Oh, Seung Han Shin, Jin Yong Shin, Ee-Kyung Kim, Hyung-Ik Shin
Several treatments have been proposed to shorten the time to the attainment of full oral feeding (FOF) for premature infants, but there are only a few evaluation methods useful in estimating predictors of this period. We investigated whether specific items within the disorganized sucking patterns described by the Neonatal Oral-Motor Assessment Scale (NOMAS) could estimate the time to FOF in preterm infants with feeding difficulty. Preterm infants diagnosed with a disorganized sucking pattern in the NOMAS evaluation before 50 weeks of postmenstrual age were included...
2018: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29534293/impact-of-smoflipid-on-pulmonary-alveolar-development-in-newborn-guinea-pigs
#7
Jean-Claude Lavoie, Ibrahim Mohamed, Anne-Monique Nuyt, Wesam Elremaly, Thérèse Rouleau
BACKGROUND: Parenteral nutrition (PN) is associated with bronchopulmonary dysplasia in premature infants. In animals, PN leads to alveolar loss following stimulation of apoptosis by oxidative stress (oxidized redox potential). Peroxides and aldehydes generated in PN can induce hypo-alveolarization. The implication of peroxides, which is reduced by light protection, is demonstrated. The implication of aldehydes from omega-6 fatty acids oxidation is expected. The hypothesis is that composition and light exposure of PN influences bronchopulmonary dysplasia development...
March 13, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29529337/copper-supplementation-in-premature-infants-with-parenteral-nutrition-associated-cholestasis
#8
Kunal Gupta, Hongyue Wang, Sanjiv B Amin
The aim of this study was to evaluate the effect of intermittent parenteral copper supplementation (IPC) on serum copper status and biochemical and hematological measures of copper toxicity and deficiency in premature infants with parenteral nutrition (PN)-associated cholestasis (PNAC). We performed a prospective nested observational study in premature infants with PNAC who received IPC after the development of PNAC. Infants with chromosomal disorders, TORCH (toxoplasmosis, parvovirus, syphilis, rubella, cytomegalovirus, herpes, human immunodeficiency virus) infection, metabolic disorder, and/or surgical abnormality of the hepatobiliary system were excluded...
March 12, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29505664/higher-versus-lower-amino-acid-intake-in-parenteral-nutrition-for-newborn-infants
#9
REVIEW
David A Osborn, Tim Schindler, Lisa J Jones, John Kh Sinn, Srinivas Bolisetty
BACKGROUND: Sick newborn and preterm infants frequently are not able to be fed enterally, necessitating parenteral fluid and nutrition. Potential benefits of higher parenteral amino acid (AA) intake for improved nitrogen balance, growth, and infant health may be outweighed by the infant's ability to utilise high intake of parenteral AA, especially in the days after birth. OBJECTIVES: The primary objective is to determine whether higher versus lower intake of parenteral AA is associated with improved growth and disability-free survival in newborn infants receiving parenteral nutrition...
March 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29505147/parenteral-protein-decision-support-system-improves-protein-delivery-in-preterm-infants-a-randomized-clinical-trial
#10
Mhd Wael Alrifai, David P Mulherin, Stuart T Weinberg, Li Wang, Christoph U Lehmann
BACKGROUND: Management of neonatal parenteral protein intake for preterm infants is challenging and requires daily modifications of the dose to account for the infant's postnatal age, birth weight, current weight, and the volume and protein concentration of concurrent enteral nutrition. The objective of this study was to create and evaluate the Parenteral Protein Calculator (PPC), a clinical decision support system to improve the accuracy of protein intake for preterm infants who require parenteral nutrition (PN)...
January 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29415837/parenteral-nutrition-associated-cholestasis-and-triglyceridemia-in-surgical-term-and-near-term-neonates-a-pilot-randomized-controlled-trial-of-two-mixed-intravenous-lipid-emulsions
#11
Luís Pereira-da-Silva, Sara Nóbrega, Maria Luísa Rosa, Marta Alves, Ana Pita, Daniel Virella, Ana Luísa Papoila, Micaela Serelha, Gonçalo Cordeiro-Ferreira, Berthold Koletzko
BACKGROUND: Cholestasis is a common complication in infants receiving prolonged parenteral nutrition (PN). We studied the effects of two intravenous lipid emulsions composed with either 30% soybean oil, 30% medium-chain triglycerides (MCT), 25% olive oil, and 15% fish oil (SMOF) or with 50% MCT and 50% soybean oil n-6 (MCT/SOY) on the incidence of cholestasis in surgical term and near-term neonates. METHODS: A single-center, double-blinded, randomized controlled trial compared the incidence of cholestasis using either SMOF or MCT/SOY in neonates born at gestational age ≥34 weeks undergoing major surgery...
December 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29338079/nutrition-delivery-and-growth-outcomes-in-infants-with-gastroschisis
#12
Charles R Hong, David Zurakowski, Brenna S Fullerton, Katelyn Ariagno, Tom Jaksic, Nilesh M Mehta
BACKGROUND: We aimed to describe nutrient intake and growth in infants with gastroschisis and identify factors associated with impaired growth. METHODS: Retrospective study of neonates who underwent gastroschisis repair from 2010 to 2015. Nutrient intake and weight-for-age z scores (WAZ) were recorded. RESULTS: Data from 60 eligible infants with median (Q1, Q3) gestational age of 36 weeks (35, 37) and birth weight 2418 g (2098, 2665) were analyzed...
January 8, 2018: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29285339/medium-chain-acyl-coa-dehydrogenase-deficiency-in-a-premature-infant
#13
Steven F Dobrowolski, Lina Ghaloul-Gonzalez, Jerry Vockley
Medium-chain acyl-CoA dehydrogenase deficiency (MCADD) is identified by newborn screening (NBS). The natural history of MCADD includes metabolic decompensation with hypoglycemia, hyperammonemia, seizures, coma, and death. NBS enables expectant management thus severe symptoms are rare in managed patients. We report premature birth of an MCADD affected infant and resultant management challenges. Nutritional support advanced from parenteral nutrition at 24 hours to enteral feeds. A NBS sample was collected day 2, positive results for MCADD was reported day six, and diagnostic tests were performed day seven...
November 21, 2017: Pediatric Reports
https://www.readbyqxmd.com/read/29240511/meeting-the-nutritional-needs-of-premature-babies-their-future-is-in-our-hands
#14
Arieh Riskin
The goals of early nutrition in preterm infants are to provide all the necessary vital nutrients, achieve extra-uterine growth rates similar to fetuses of the same gestational age, and support functional neurodevelopmental outcomes that are comparable to those of infants born at term. It is vital to provide nutrition that will maximally support brain growth and development, but over-feeding with accelerated growth, fat accumulation and long-term metabolic consequences should also be avoided. Because the morbidity associated with prematurity increases nutritional and energetic demands, the basic approach is of providing early intensive nutrition...
December 2, 2017: British Journal of Hospital Medicine
https://www.readbyqxmd.com/read/29198532/impact-of-prolonged-mechanical-ventilation-in-very-low-birth-weight-infants-results-from-a-national-cohort-study
#15
Young-Bin Choi, Juyoung Lee, Jisun Park, Yong Hoon Jun
OBJECTIVE: To evaluate the in-hospital consequences of prolonged respiratory support with invasive mechanical ventilation in very low birth weight infants. STUDY DESIGN: A cohort study was performed using prospectively collected data from 69 neonatal intensive care units participating in the Korean national registry. In total, 3508 very low birth weight infants born between January 1, 2013 and December 31, 2014 were reviewed. RESULTS: The adjusted hazard ratio for death increased significantly for infants who received mechanical ventilation for more than 2 weeks compared with those were mechanically ventilated for 7 days or less...
March 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29187120/growth-and-neurodevelopmental-outcomes-of-early-high-dose-parenteral-amino-acid-intake-in-very-low-birth-weight-infants-a-randomized-controlled-trial
#16
Maya Balakrishnan, Alishia Jennings, Lynn Przystac, Chanika Phornphutkul, Richard Tucker, Betty Vohr, Bonnie E Stephens, Joseph M Bliss
BACKGROUND: Administration of high-dose parenteral amino acids (AAs) to premature infants within hours of delivery is currently recommended. This study compared the effect of lower and higher AA administration starting close to birth on short-term growth and neurodevelopmental outcomes at 18-24 months corrected gestational age (CGA). METHODS: Infants <1250 g birth weight (n = 168) were randomly assigned in a blinded fashion to receive parenteral nutrition providing 1-2 g/kg/d AA and advancing daily by 0...
March 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29168220/number-needed-to-suffer-replying-to-comments-on-my-paper
#17
Per-Arne Lönnqvist
I would like to reply to the issues raised by the letter from Dr Barrington (1) on my Different View article on disability-free survival and number needed to suffer (2). However, first of all I would like to provide some important background on my interest in this area.First, I worked in NICU care for more than 10 years before focusing on paediatric anaesthesia and I am the proud father of premature triplets born at 31+4 weeks. As such, I have also been a parent who has witnessed NICU care three times for three months, including surfactant replacement, mechanical ventilation, surgical ductus ligation, sepsis and necrotising entercolitis treated by nil-by-mouth, total parenteral nutrition and antibiotics...
November 23, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/29072164/effects-of-a-lipid-emulsion-containing-fish-oil-on-polyunsaturated-fatty-acid-profiles-growth-and-morbidities-in-extremely-premature-infants-a-randomized-controlled-trial
#18
Svetlana Najm, Chatarina Löfqvist, Gunnel Hellgren, Eva Engström, Pia Lundgren, Anna-Lena Hård, Alexandre Lapillonne, Karin Sävman, Anders K Nilsson, Mats X Andersson, Lois E H Smith, Ann Hellström
BACKGROUND & AIMS: The purpose of the study was to compare the effects of the parenteral emulsion SMOFlipid® , with 15% fish oil, with Clinoleic® on retinopathy of prematurity (ROP) and other morbidities and growth, and to compare their impact on longitudinal serum levels of fatty acids. Retinopathy of prematurity, other morbidity and growth were correlated with each parenteral lipid supplement. METHODS: Ninety infants born at gestational age <28 weeks were randomized to treatment with SMOFlipid® or Clinoleic® ...
August 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29072041/epidemiology-of-serratia-marcescens-infections-in-nicu-of-a-teaching-and-research-hospital-in-northern-italy
#19
Elisa Buttinelli, Ilaria Ardoino, Giulia Domeniconi, Monica Lanzoni, Lorenza Pugni, Andrea Ronchi, Fabio Mosca, Elia Biganzoli, Silvana Castaldi
BACKGROUND: Serratia marcescens (Sm) is a known cause of infection and colonization in neonates receiving intensive care. The aim of this study was to identify the risk factors for colonization and infection with Sm in Neonatal Intensive Care Unit (NICU) of a tertiary care Hospital. METHODS: A casecontrol study was conducted from January to December 2011 in neonates admitted to the NICU. Cases are patients with a microbiologically confirmed infection or colonization, controls were randomly chosen among patients admitted to the same NICU...
October 25, 2017: Minerva Pediatrica
https://www.readbyqxmd.com/read/29030727/-parenteral-nutrition-in-premature-babies-with-a-birth-weight-1500g-a-systematic-single-center-analysis-and-comparison-with-current-guidelines
#20
Melanie Sirch, Martin Poryo, Mona Butte, Ulrike Lindner, Ludwig Gortner, Michael Zemlin, Holger Nunold, Sascha Meyer
BACKGROUND: Parenteral and enteral nutrition are essential for both growth and development of preterm infants. Based on the results of many studies, the rate of nutritional growth and the amount of substrate delivered parenterally are under debate. OBJECTIVE: The main aim of this study was to assess parenteral nutrition in very and extremely immature preterm infants, i.e. very low birth weight (VLBW, birth weight <1500g) and extremely low birth weight (ELBW, birth weight <1000g) neonates, and to compare the amount of parenterally delivered substrate in our neonatal intensive care unit (NICU) to current German guidelines...
October 13, 2017: Wiener Medizinische Wochenschrift
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