Perioperative nutrition in extremely preterm infants undergoing surgical treatment for patent ductus arteriosus is suboptimal

Abstract

Perioperative nutrition in extremely preterm infants undergoing PDA surgery in Sweden is suboptimal and needs to be improved. The significance of malnutrition for outcome after PDA surgery remains unclear and requires further investigation.

Postnatal growth in preterm infants and later health outcomes: a systematic review

“…A recent systematic review found that early parenteral nutrition in preterm infants improves short‐term growth outcomes . Among very preterm infants nutrition is often suboptimal , and while there is yet no evidence linking progressive advancement of enteral milk feeds to risk of adverse short‐term outcomes, such as necrotising enterocolitis and late‐onset infection, the need for further trials is recognised .…”

Preterm Birth Is Associated with Altered Myocardial Function in Infancy

“…Secondly, many preterm infants suffer from severe undernutrition during the first weeks of life 152 . This insufficient nutritional status is not just present in infants with fluid restriction 153 . The current recommendations for preterm infants are to provide nutrients that are approximately the same as the requirements for the rate of growth and composition of weight gain for a normal fetus of the same conceptional age.…”

Perioperative nutrition in extremely preterm infants undergoing surgery for patent ductus arteriosus

“…Perinatal and morbidity data within the EXPRESS cohort were prospectively registered in the Swedish neonatal quality register by physicians and nurses and has previously been published [1,18], nutritional intakes regarding infants who underwent PDA-surgery has also been published [17]. Briefly, detailed nutritional intakes were retrospectively obtained from hospital records for the perioperative week from three days pre-surgery (-3 days), day of surgery (day 0) to three days post-surgery (þ3 days).…”

“…Energy and macronutrient intakes from enteral nutrition and parenteral nutrition were calculated using information from the manufacturers and breast milk analyses [6]. Nutritional intakes of energy, macronutrients and fluids were assessed in kcal/kg/day, grams/kg/day and mL/kg/day, respectively [6,17]. Nutritional intakes during the perioperative week were compared between NICUs and to minimal estimated nutritional needs of 110 kcal/kg/day, 4 g protein/kg/day, 4.8 g fat/kg/day, and 12 g carbohydrates/100 kcal [17], based on international nutritional guidelines [7,21].…”

“…Infants' postnatal age and nutritional intakes when undergoing PDA-surgery vary, since its hemodynamic significance varies over time and because optimal postnatal age and indications for PDAsurgery are still debated [16]. Recent studies have demonstrated the existence of suboptimal nutrition in EPT infants in general but also during the perioperative week surrounding PDA-surgery [6,17]. Still, research in these areas is very sparse.…”