ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition

Mihatsch, Walter A.; Braegger, Christian; Bronský, Jiří; Cai, Wei; Campoy, Cristina; Carnielli, Virgilio P.; Darmaun, Dominique; Desci, T; 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; 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, Ronen; Simchowitz, Venetia; Szitányi, Peter; Tabbers, Merit M.; Akker, Chris H.P. van den; Goudoever, Johannes B. van; Kempen, Anne A. M. W. van; Verbruggen, Sascha; Wu, Jiang; Yan, Wei

doi:10.1016/j.clnu.2018.05.029

Cited by 103 publications

(111 citation statements)

References 14 publications

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“…Early initiation of higher levels of parenteral amino acids results in less postnatal growth failure and an increase in positive protein balance [163]. At least 1.5 g/kg intravenous protein [164] and 1–2 g/kg lipids should be started from day one and increased to a maximum of 3.5 g/kg amino acid [165]. For stable infants, a small amount (0.5–1 mL/kg/h) of breast milk can be started early to initiate enteral feeding [166].…”

Section: Monitoring and Supportive Carementioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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As management of respiratory distress syndrome (RDS) advances, clinicians must continually revise their current practice. We report the fourth update of “European Guidelines for the Management of RDS” by a European panel of experienced neonatologists and an expert perinatal obstetrician based on available literature up to the end of 2018. Optimising outcome for babies with RDS includes prediction of risk of preterm delivery, need for appropriate maternal transfer to a perinatal centre and timely use of antenatal steroids. Delivery room management has become more evidence-based, and protocols for lung protection including initiation of CPAP and titration of oxygen should be implemented immediately after birth. Surfactant replacement therapy is a crucial part of management of RDS, and newer protocols for its use recommend early administration and avoidance of mechanical ventilation. Methods of maintaining babies on non-invasive respiratory support have been further developed and may cause less distress and reduce chronic lung disease. As technology for delivering mechanical ventilation improves, the risk of causing lung injury should decrease, although minimising time spent on mechanical ventilation using caffeine and, if necessary, postnatal steroids are also important considerations. Protocols for optimising general care of infants with RDS are also essential with good temperature control, careful fluid and nutritional management, maintenance of perfusion and judicious use of antibiotics all being important determinants of best outcome.

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Section: Monitoring and Supportive Carementioning

confidence: 99%

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

et al. 2019

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“…Prescriptions for PN were carried out daily between 8:00am and 12:30pm by the physician in the NICU in accordance with international guidelines (ESPGHAN) [1]. Taken into account are the clinical condition of the patient, including the weight; biological laboratory assessment, nutritional needs; postnatal age, and constraints related to pharmacy compounding.…”

Section: Overview Of the Processmentioning

confidence: 99%

“…The energy intake necessary to ensure their growth is very high during this period (45-120 kcal/kg/day according to the post-natal age) [1,2]. Enteral nutrition through breast milk should be preferred when the digestive tract is functional, improving preterm infant growth and reducing adverse events related to central catheter lines [1]. When the gastrointestinal tract is dysfunctional or inaccessible (cannot initiate enteral nutrition, necrotizing enterocolitis, gastrostomy), parenteral nutrition (PN) is used.…”

Section: Introductionmentioning

confidence: 99%

Controlling Risks in the Compounding Process of Individually Formulated Parenteral Nutrition: Use of the FMECA Method (Failure modes, effects, and Criticality Analysis)

Royer

Libessart

Dubaele

et al. 2020

Pharmaceutical Technology in Hospital Pharmacy

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AbstractParenteral nutrition (PN) in the neonatal intensive care unit (NICU) involves a succession of risky processes. The objective was to identify and prioritize the risks associated with PN in order to improve the quality of the pathway. A failure modes, effects, and criticality analysis (FMECA) was used to identify potential PN pathway failure modes. A multidisciplinary working group conducted a functional analysis of the processes, then listed the failure modes (FM). The FM criticality was assessed on a scale from 1 to 5 for occurrence (O), severity (S), and detection (D). The risk priority number (RPN), ranging from 1 to 125, was calculated. The FMECA identified 99 FM (prescription (n=28), preparation (n=48), and administration (n=23)). The median RPN was 12, with scores ranging from 3 to 48. 25 % of the scores had an RPN>21.75.Among them, 12 were associated with prescription FM, 5 were associated with FM related to preparation and 8 were associated with a FM linked to administration. It allowed us to prioritize areas of potential quality improvement for parenteral nutrition of the preterm infant. The results demonstrated the need for the presence of a clinical pharmacist in the NICU to ensure the quality of PN process.

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“…3,4 While clear evidence for the optimal postnatal nutrition strategy to achieve this neonatal care goal is lacking, systematic reviews, international consensus nutrition recommendations and best practice guidelines based on the available evidence have been published. [5][6][7] However, surveys of neonatal nutrition practice in the United States, Britain, Europe, New Zealand and Australia demonstrate most neonatal units do not achieve the recommended nutrient intakes for preterm babies. 8,9 There are two likely causes for this.…”

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confidence: 99%

Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

Cormack

Oliver

Farrent

et al. 2019

Nutrition & Dietetics

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Aim: Dietitian-led implementation of evidence-based nutrition support practices improves nutrient intakes, clinical outcomes and growth, decreases length of stay and related costs, and reduces intravenous nutrition costs and prescription errors. We aimed to investigate current neonatal dietitian resourcing and roles in New Zealand and Australian neonatal units, and to compare this with dietitian workforce recommendations and previously reported survey data. Methods: A two-part electronic survey was emailed to 50 Australasian Neonatal Dietitians Network members and other dietitians working in neonatal intensive care or special care baby units in New Zealand and Australia. The survey ran from July to October 2018. Descriptive statistics were used to examine the distribution of responses. Responses were compared with other similar surveys and British Dietetic Association workforce recommendations.

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ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition

Cited by 103 publications

References 14 publications

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

European Consensus Guidelines on the Management of Respiratory Distress Syndrome – 2019 Update

Controlling Risks in the Compounding Process of Individually Formulated Parenteral Nutrition: Use of the FMECA Method (Failure modes, effects, and Criticality Analysis)

Neonatal dietitian resourcing and roles in New Zealand and Australia: A survey of current practice

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