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

Abstract

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.

A Retrospective Study Evaluating Guideline Adherence of Neonatal Parenteral Nutrition in a Belgian Neonatal Intensive Care Unit

“…Macronutrients supplied via PN were calculated using the Nutriscript software (Fresenius Kabi NV/SA). Thus, data on daily PN intakes for energy and macronutrients were derived from the prescriptions (fluid volumes as previously described in Batteux et al [23]). All other parameters were extracted from electronic medical files, including the start of PN, stop of PN, and GA, as well as birth data for weight and length.…”

“…Surveys found adherence to guidelines for PN in neonates to vary widely between European centers, and provision was often inadequate [20,21]. However, very few studies have compared the 2018 ESPGHAN guideline recommendations with current routine practice in the parenteral feeding of neonates [22,23].…”