Early or delayed parenteral nutrition for infants: what evidence is available?
| Autor: | Kwi Moon, Shripada Rao |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Pediatrics medicine.medical_specialty 030109 nutrition & dietetics Nutrition and Dietetics business.industry Day of life Medicine (miscellaneous) 030208 emergency & critical care medicine Metabolic acidosis Serum phosphate medicine.disease Elevated blood law.invention 03 medical and health sciences 0302 clinical medicine Parenteral nutrition Randomized controlled trial law medicine Breathing High doses business |
| Zdroj: | Current Opinion in Clinical Nutrition & Metabolic Care. 24:281-286 |
| ISSN: | 1473-6519 1363-1950 |
| DOI: | 10.1097/mco.0000000000000720 |
| Popis: | Purpose of review To review the current evidence evaluating early versus delayed commencement of parenteral nutrition in infants. Recent findings Recent studies in very premature infants ( 3.5 g/kg/day immediately after birth) may cause metabolic acidosis, elevated blood urea, slower head growth and refeeding-hypophosphatemia syndrome. A recent multicentre randomized controlled trial found that commencement of parenteral nutrition within 24-h of admission increases the risk of infections and prolongs the duration of ventilation and ICU stay in full-term neonates, older infants and children. The study also found that delaying to day 8 of admission increased the risk of hypoglycaemia. Summary Benefits of commencing parenteral nutrition on the first day of life appear to outweigh risks in very premature infants; however, it is prudent to avoid early very high doses of amino acids (>3.5 g/kg/day) in the first few days of life. In moderate to late preterm infants, if enteral feeds are not tolerated by 72 h, it is reasonable to commence parenteral nutrition. In full-term and older infants, it is preferable to avoid parenteral nutrition within 24 h of admission and consider delaying by further few days. Diligent monitoring of blood glucose, serum phosphate and other parameters is essential while on parenteral nutrition. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|