A triple‐chamber parenteral nutrition solution was associated with improved protein intake in very low birthweight infants

Abstract

We evaluated the nutrient intakes of very low birthweight (VLBW) infants weighing less than 1500g and tested the hypothesis that using a triple-chamber parenteral nutrition (PN) solution, containing lipids, glucose and amino acids, would improve protein intake. MethodsThis retrospective cohort study comprised 953 VLBW infants born in 2005-2013 at a gestational age of less than 32+0/7 weeks and admitted to the neonatal care unit at Helsinki Children's Hospital, Finland. The infants were divided into four groups according their birth year and PN regime. Nutrient intakes were obtained from computerised medication administration records. ResultsIn 2012-2013, when a triple-chamber PN solution was used, infants were more likely to reach the target parenteral protein intake of 3.5g/kg/d, and reach it 3-7 days earlier, compared with infants who received individual PN or standard two-in-one PN solutions in 2005-2011. In addition, infants in the triple-chamber group had the highest median energy intake (90kcal/kg/d) during the first week. They also had higher median protein intakes in weeks one, two and three (3.1, 3.4 and 3.7g/kg/d) than infants born in 2005-2011 (p<0.05). ConclusionUsing a triple-chamber PN solution was associated with improved protein intake and the protein target was more likely to be achieved.

Length of Nutritional Transition Associates Negatively with Postnatal Growth in Very Low Birthweight Infants

“…Data on the background characteristics and postnatal morbidities, except for sepsis, were retrieved from the Finnish Medical Birth Register, which is managed by the Finnish Institute for Health and Welfare. A detailed description of the Medical Birth Register data used has been described previously [8,9]. Gestational age was determined from the first day of the last menstrual period and confirmed by ultrasonography in 84% of cases.…”

“…According to our unit s policy, parenteral nutrition was started immediately after birth as soon as intravenous access was available, and it was generally discontinued when enteral feeds exceeded 120 mL/kg/d. During the study period, the implementation of the PN varied between individual solutions, standard 2-in-1, and triple-chamber PN solutions [8]. Enteral nutrition was started during the first day of life with minimal amounts of the mother's own milk or donor human milk, and the amount was gradually increased by 10-20 mL/kg/d, according to tolerance.…”

Standardization of parenteral nutrition – a review of protocol development in a tertiary neonatal setup

“…18,20 Although the use of 3-in-1 PN solutions is not necessarily therapeutically advantageous, certain benefits may exist such as the potential to reduce the risk of contamination due to decreased manipulations, ease of administration, cost effectiveness and reduced IVFE wastage. 21 Both these types of infusion make sure that the contents of the bag remain separate and in their pure form till right before they are used. The literature suggests no superiority of one over the other.…”

Modern Experience of Parenteral Nutrition With Standardized Preparations of Industrial Production in Pediatric Practice: Literature Review

“…У наступному дослідженні, опублікованому у 2020 році, оцінювалося споживання поживних речовин у немовлят з дуже малою масою при народженні (< 1500 г) та проводилася перевірка гіпотези про використання трикамерного розчину СП ПЕХ для парентерального харчування промислового виробництва з ліпідами, глюкозою та амінокислотами, що покращить споживання білка [27]. Ретроспективне когортне дослідження охопило 953 немовлят з дуже малою масою при народженні, які народились у 2005-2013 роках у терміні гестації менше 32 + 0/7 тижнів та потрапили до відділення неонатальної допомоги в Гельсінкську дитячу лікарню, Фінляндія.…”

“…(р < 0.05). Таким чином, використання трикамерного розчину СП ПЕХ асоціювалось із покращеним споживанням білка, і мета, спрямована на дотацію білка, швидше за все, була досягнута [27].…”