Improving extrauterine growth: evaluation of an optimized, standardized neonatal parenteral nutrition protocol

Darrow, Maj Cory J; Li, Hong; Prince, Allison; McClary, Jacquelyn; Walsh, Michele C.

doi:10.1038/s41372-018-0279-4

Cited by 5 publications

(5 citation statements)

References 23 publications

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“…Although the significance of the presence of EUGR disappeared after logistic regression analysis, the statistical differences of z-score of BW, Δz-score of BW at TEA persisted after multivariate linear regression analysis. The results were compatible with previous studies that showed a standardized nutritional protocol could reduce the incidence of EUGR in preterm infants [ 12 , 15 ]. The lower Δz-score of BW at TEA could explain why the patients in Epoch-II had a higher z-score of BW at TEA while comparing with those in Epoch-I.…”

Section: Discussionsupporting

confidence: 92%

“…To minimize the prevalence of EUGR, standardized nutritional protocols have been proposed in recent years. Early trophic feeding (ETF) and optimal parenteral nutrition (PN) supplements have been recommended to be implemented in every neonatal intensive care unit (NICU) by several studies [ 12 , 13 , 14 , 15 , 16 , 17 ]. However, in practice, discrepancies between city and rural institutions have been largely overlooked despite the well-known benefits of ETF reported [ 18 , 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, in practice, discrepancies between city and rural institutions have been largely overlooked despite the well-known benefits of ETF reported [ 18 , 19 , 20 ]. In rural hospitals, enteral feeding could be delayed due to the fear of necrotizing enterocolitis (NEC) and the shortage of pediatric surgeons [ 13 , 15 , 21 ]. The accessibility of a human milk bank (HMB) could be an important factor associated with initiating ETF.…”

Section: Introductionmentioning

confidence: 99%

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Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

et al. 2022

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The extrauterine growth restriction (EUGR) of very preterm infants has been associated with long-term complications and neurodevelopmental problems. EUGR has been reported at higher rates in low resource settings. There is limited research investigating how metropolitan human milk banks contribute to the growth outcomes of very preterm infants cared in rural areas. The setting of this study is located at a rural county in Taiwan and affiliated with the Taiwan Southern Human Milk Bank. Donor human milk was provided through a novel supplemental system. A renewal nutritional protocol was initiated as a quality improvement project after the affiliated program. This study aimed to compare the clinical morbidities and growth outcome at term equivalent age (TEA) of preterm infants less than 33 weeks of gestational age before (Epoch-I, July 2015–June 2018, n = 40) and after the new implementation (Epoch-II, July 2018–December 2020, n = 42). The Epoch-II group significantly increased in bodyweight z-score at TEA ((−0.02 ± 1.00) versus Epoch-I group (−0.84 ± 1.08), p = 0.002). In multivariate regression models, the statistical difference between two epochs in bodyweight z-score changes from birth to TEA was still noted. Modern human milk banks may facilitate the nutritional protocol renewal in rural areas and improve the growth outcomes of very preterm infants cared for. Establishing more distribution sites of milk banks should be encouraged.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

et al. 2022

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“…Several studies support the positive impact of early parenteral nutrition (PN) on preterm infants’ weight, length, and head circumference [ 4 , 5 , 6 ]. In conjunction, observational studies linked this early growth with later neurodevelopment in both childhood [ 7 ] and till adulthood [ 8 , 9 ].…”

Section: Introductionmentioning

confidence: 99%

Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants

et al. 2022

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Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). Enhanced early PN was not associated with improved neurodevelopment; however, first-week enteral caloric and protein intake were associated with improved speed of processing.

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“…Conceituando a prematuridade e o baixo peso ao nascer como condições de risco de grande relevância para a morbidade e mortalidade infantil, se fazem necessários esforços contínuos para ampliar as intervenções comprovadas de pronto atendimento neonatal para promover o adequado suporte ao recém-nascido e a implantação de protocolos 23 . Acredita-se que a padronização de protocolos nos cuidados intensivos e nutricionais neonatais pode ajudar a melhorar o crescimento pós-natal dos recémnascidos pré-termo 24 . A avaliação do crescimento dos recém-nascidos e lactentes é um procedimento rotineiro realizado com a obtenção de medidas antropométricas que deverão ser comparadas com os dados fornecidos por gráficos ou tabelas padronizados, de acordo com a idade gestacional e o sexo, e apresentados na forma de percentil ou escore "Z" 25 .…”

Section: Crescimento E Antropometria Neonatalunclassified

Características da cavidade oral edêntula e do crescimento orofacial dos lactentes nascidos pré-termo de muito baixo peso

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Improving extrauterine growth: evaluation of an optimized, standardized neonatal parenteral nutrition protocol

Cited by 5 publications

References 23 publications

Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

Growth of Very Preterm Infants in a Low-Resourced Rural Setting after Affiliation with a Human Milk Bank

Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants

Características da cavidade oral edêntula e do crescimento orofacial dos lactentes nascidos pré-termo de muito baixo peso

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