Comparison Between Sodium Acetate and Sodium Chloride in Parenteral Nutrition for Very Preterm Infants on the Acid-Base Status and Neonatal Outcomes.

Autor: Ali A; Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia., Ong EY; Department of Pharmacy, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Sadu Singh BK; Department of Pharmacy, University Kebangsaan Malaysia Medical Center, Kuala Lumpur, Malaysia., Cheah FC; Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
Jazyk: angličtina
Zdroj: Pediatric gastroenterology, hepatology & nutrition [Pediatr Gastroenterol Hepatol Nutr] 2020 Jul; Vol. 23 (4), pp. 377-387. Date of Electronic Publication: 2020 Jul 03.
DOI: 10.5223/pghn.2020.23.4.377
Abstrakt: Purpose: To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants.
Methods: Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise.
Results: Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE -1.6 vs. -3.5 [ p <0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p =0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p <0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups.
Conclusion: The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.
Competing Interests: Conflict of Interest: The authors have no financial conflicts of interest.
(Copyright © 2020 by The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition.)
Databáze: MEDLINE
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