ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Fluid and electrolytes

Braegger, Christian; Bronský, Jiří; Cai, Wei; Campoy, Cristina; Carnielli, Virgilio P.; Darmaun, Dominique; Décsi, Támas; Domellöf, Magnus; Embleton, Nicholas D.; Fewtrell, Mary; Mis, Nataša Fidler; Franz, Axel; Goulet, Olivier; Hartman, Corina; Hill, Susan; Hojsak, Iva; Iacobelli, Simona; Jochum, Frank; Joosten, Koen; Kolaček, Sanja; Koletzko, Berthold; Książyk, Janusz; Lapillonne, Alexandre; Lohner, Szimonetta; Mesotten, Dieter; Mihályi, Krisztina; Mihatsch, Walter A.; Mimouni, Francis; Mølgaard, Christian; Moltu, Sissel J.; Nomayo, Antonia; Picaud, Jean Charles; Prell, Christine; Puntis, John; Riskin, Arieh; Pipaón, Miguel Sáenz de; Senterre, Thibault; Shamir, Raanan; Simchowitz, Venetia; Szitányi, Peter; Tabbers, Merit M.; Akker, Chris H.B. Van Den; Goudoever, Johannes B. van; Kempen, Anne A. M. W. van; Verbruggen, Sascha; Wu, Jiang; Yan, Weihui

doi:10.1016/j.clnu.2018.06.948

Cited by 101 publications

(114 citation statements)

References 87 publications

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“…Two groups were retrospectively compared before and after the introduction of the new guidelines in 2005. The fluid recommendation for infants with a birthweight of <1000 g was identical to the lower limit of the new European guidelines during the first 3 days of life. For infants with a birthweight of 1000‐1500 g, it was more restricted, at 60‐100 mL/kg/d.…”

Section: Discussioncontrasting

confidence: 89%

“…A clinically important finding was that fluid intake from flushes accounted for 160-180 mL/kg/d by day five. 7 In our study, the actual fluid intake in VLBW infants was higher than the European guidelines 7,17 during the first 3 days of life. In the most premature group, with a GA of 23-26 weeks, the median total fluid intake had already exceeded 150 mL/kg/d on day one.…”

Section: Discussionmentioning

confidence: 43%

“…New European guidelines on paediatric parenteral nutrition were published in 2018, and these contained minor changes to the fluid intake recommendations. The new guidelines recommend that fluid intake in preterm neonates with a birthweight of <1000 g should start at 80‐100 mL/kg/d and at 70‐90 mL/kg/d in those with birthweights between 1000 and 1500 g. In both groups, the fluid intake should be gradually increased with increments of 20‐30 mL/kg/d up to 160‐180 mL/kg/d by day five . In our study, the actual fluid intake in VLBW infants was higher than the European guidelines during the first 3 days of life.…”

Section: Discussionmentioning

confidence: 99%

“…In our unit, nutritional practices follow the European guidelines on parenteral and enteral nutrition . Parenteral nutrition is started for all VLBW infants after birth as soon as an intravenous line is available.…”

Section: Methodsmentioning

confidence: 99%

“…In our unit, nutritional practices follow the European guidelines on parenteral and enteral nutrition. 7,17,18 Parenteral nutrition is started for all VLBW infants after birth as soon as an intravenous line is available. Enteral feeds are initiated on the first day of life, with 1-2 mL of mother's milk or donor human milk every 3 hours, and gradually increased by 10-20 mL/kg/d according to tolerance.…”

Section: Key Notesmentioning

confidence: 99%

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Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week

et al. 2019

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Aim We examined actual fluid intake, and routes of administration, in very low birthweight (VLBW) infants during the first week of life in a neonatal intensive care unit. Methods This retrospective cohort study comprised 953 infants born at <32 weeks and 1500 g and treated at Helsinki University Children's Hospital from 2005 to 2013. All parenterally and enterally administered fluids, and their sources, were obtained from our patient information system. Infants were divided into three groups according to their gestational age: 23‐26, 27‐29 and 30‐31 weeks. Results Fluid intake exceeded European guidelines during the first 3 days. On days 1‐7, total fluid intake was highest in the most premature group (P < .001) and the median total fluid intake in this group peaked at 177 mL/kg/d (IQR 154‐209) on day three. Intravascular flushes provided a considerable source of fluids, with the median intake in the most preterm group peaking at 26.4 mL/kg/d, which represented 15.6% of total fluid intake. Conclusion During the first 3 days of life, our VLBW infants had a higher total fluid intake than the European guidelines. A considerable percentage came from hidden sources, such as saline flushes, which should be taken into account when prescribing fluids.

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Section: Discussioncontrasting

confidence: 89%

Section: Discussionmentioning

confidence: 43%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Key Notesmentioning

confidence: 99%

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Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week

et al. 2019

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Higher versus lower sodium intake for preterm infants

Diller,

Osborn,

Birch

2023

Cochrane Database of Systematic Reviews

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Monitoring of long‐term parenteral nutrition in children with intestinal failure

Zemrani

Bines

2019

JGH Open

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Pediatric intestinal failure (IF) is a rare and complex condition associated with significant morbidity and mortality. It is defined as the reduction of gut mass or function below the minimal needed for absorption of nutrients and fluid to sustain life and growth. Since the advent of specialized multidisciplinary intestinal rehabilitation centers, IF management has considerably evolved in the last years, but serious complications of long‐term parenteral nutrition (PN) can occur. Main complications include intestinal failure‐associated liver disease, growth failure, body composition imbalance, central venous access complications, micronutrient deficiencies and toxicities, metabolic bone disease, small intestinal bacterial overgrowth, and renal disease. With improvement in survival rates of patients over the last 20 years, emphasis should be on limiting IF‐related comorbidities and improving quality of life. Close monitoring is pivotal to ensuring quality of care of these patients. The care of children with chronic IF should involve a comprehensive monitoring plan with flexibility for individualization according to specific patient needs. Monitoring of children on long‐term PN varies significantly across units and is mainly based on experience, although few guidelines exist. This narrative review summarizes the current knowledge and practices related to monitoring of children with IF. The authors also share their 20‐year experience at the Royal Children's Hospital in Melbourne Australia on this topic.

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ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Fluid and electrolytes

Cited by 101 publications

References 87 publications

Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week

Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week

Higher versus lower sodium intake for preterm infants

Monitoring of long‐term parenteral nutrition in children with intestinal failure

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