Systematic Review on Individualized Versus Standardized Parenteral Nutrition in Preterm Infants

Mihatsch, Walter A.; Varas, Miguel Ángel Jiménez; Diehl, Lucia Lorenzino; Carnielli, Virgilio P.; Schuler, Rahel; Gebauer, Corinna; Pipaón, Miguel Sáenz de

doi:10.3390/nu15051224

Cited by 6 publications

(3 citation statements)

References 36 publications

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“…12 PN is started early after birth to bridge the transition from placental nutrition to enteral feeding. 13 Few studies have discussed the relationship between the duration of PN and the length of stay in preterm infants. This study found that the longer the duration of PN, the longer the hospitalization of preterm infants, with a strongly positive correlation coefficient = 0.627.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia

Putri Prashanti,

Kanthi Soraca Widiatmika,

Putu Siska Suryaningsih

et al. 2023

Bioscmed

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Background: Advances in neonatology have led to many preterm infants being saved. Prolonged length of stay (LOS) increases the incidence of neonatal complications and even mortality, placing a significant economic burden on families and strain on healthcare systems. This study aims to determine the factors associated with LOS in preterm infants. Methods: This cross-sectional study involved 60 preterm babies treated at Wangaya Hospital from May 2022 to May 2023. Infants with congenital anomalies, referred from other hospitals and did not receive appropriate treatment were excluded from the study. Data were taken from the electronic medical record after obtaining ethical clearance and then analyzed using descriptive statistics and linear regression in SPSS 25. Statistical significance was considered at 0.05. Results: As many as 46 out of 60 preterm infants were born at moderate to late preterm gestational age. The majority of 81.7% of infants were born with a body weight of 1500-2499 grams. The median number of LOS was 7.5 days (IQR 15). Multivariate analysis of numerical independent variables obtained an equation log [LOS] = 2.902-0.066*gestational age+ 0.022*duration of parenteral nutrition (R2 = 78.1%). Meanwhile, in the categorical independent variables obtained, an equation log [LOS] = 0.398 + 0.223*very preterm + 0.144* RDS + 0.178*NEC + 0.206*prolonged antibiotics administration + 0.278*late enteral feeding + 0.148*abdominal distension + 0.144*vomiting (R2 = 87.4%). Conclusion: Factors influencing LOS of preterm infants are gestational age, duration of parenteral nutrition, the presence of RDS, NEC, vomiting, abdominal distension, late enteral feeding, and prolonged use of antibiotics. It is essential to carry out antenatal care for pregnant women to prevent premature birth.

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Section: Discussionmentioning

confidence: 99%

Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia

Putri Prashanti,

Kanthi Soraca Widiatmika,

Putu Siska Suryaningsih

et al. 2023

Bioscmed

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“…Overall, the choice of parenteral nutrition type (PN, SPN, or IPN) remains controversial, with the available studies providing very limited evidence [ 22 ]: SPN did not seem to lower rates of death, sepsis, or NEC, and PN duration compared to IPN [ 19 , 22 ]. To assess the true clinical benefit of SPN compared to IPN, sufficiently powered randomized controlled trials—RCTs—are needed, especially in lower gestational age cohorts and when surgery is needed.…”

Section: Standard Versus Individualized Parenteral Nutritionmentioning

confidence: 99%

Nutritional Strategies for Preterm Neonates and Preterm Neonates Undergoing Surgery: New Insights for Practice and Wrong Beliefs to Uproot

De Rose,

Lapillonne,

Iacobelli

et al. 2024

Nutrients

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The nutrition of preterm infants remains contaminated by wrong beliefs that reflect inexactitudes and perpetuate old practices. In this narrative review, we report current evidence in preterm neonates and in preterm neonates undergoing surgery. Convictions that necrotizing enterocolitis is reduced by the delay in introducing enteral feeding, a slow advancement in enteral feeds, and the systematic control of residual gastric volumes, should be abandoned. On the contrary, these practices prolong the time to reach full enteral feeding. The length of parenteral nutrition should be as short as possible to reduce the infectious risk. Intrauterine growth restriction, hemodynamic and respiratory instability, and patent ductus arteriosus should be considered in advancing enteral feeds, but they must not translate into prolonged fasting, which can be equally dangerous. Clinicians should also keep in mind the risk of refeeding syndrome in case of high amino acid intake and inadequate electrolyte supply, closely monitoring them. Conversely, when preterm infants undergo surgery, nutritional strategies are still based on retrospective studies and opinions rather than on randomized controlled trials. Finally, this review also highlights how the use of adequately fortified human milk is strongly recommended, as it offers unique benefits for immune and gastrointestinal health and neurodevelopmental outcomes.

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“…Since the introduction of the first standardized PN formulations for neonates, its benefits and risks have been intensively discussed. [5][6][7] Many clinicians approve the "one size fits all"-approach, [8][9][10] even if it appears counterintuitive that it can feed neonates adequately, especially preterms and critically ill newborns. Today, guidelines generally recommend standardized PN solutions over individualized PN (IPN) for most newborns, including very low birth weight (VLBW) infants.…”

Section: Introductionmentioning

confidence: 99%

The Use of Standardized Solutions Instead of Individualized Prescriptions for Parenteral Nutrition on the Neonatal Intensive Care Unit in UZ Brussel: A Feasibility Study

Batteux,

Meers,

Fien

et al. 2023

Clin Pediatr (Phila)

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For parenteral nutrition (PN) of newborns, the European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) 2018 guidelines recommend standardized solutions over individual PN (IPN) solutions for most patients. This retrospective study assessed if a shift from IPN to standardized PN was feasible at the UZ Brussel. Using prescription data of 145 neonates, we calculated the nutrient provision for IPN and for standardized PN of the same volumes. We compared the macronutrient intakes with ESPGHAN 2018 recommendations to assess the feasibility. For neonates of a gestational age (GA) <32 or >36 weeks, standardized PN reached recommendations as least as fast as IPN. For neonates with a GA of 32 to 36 weeks, the administration protocol requires further adjustments as amino acid provision was lacking compared to IPN. Overall, the results support the feasibility of a shift from IPN to standardized PN at the UZ Brussel.

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Systematic Review on Individualized Versus Standardized Parenteral Nutrition in Preterm Infants

Cited by 6 publications

References 36 publications

Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia

Risk Factors Affecting Length of Stay in Preterm Infants at Wangaya Regional General Hospital, Indonesia

Nutritional Strategies for Preterm Neonates and Preterm Neonates Undergoing Surgery: New Insights for Practice and Wrong Beliefs to Uproot

The Use of Standardized Solutions Instead of Individualized Prescriptions for Parenteral Nutrition on the Neonatal Intensive Care Unit in UZ Brussel: A Feasibility Study

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