Impact of a standardised parenteral nutrition protocol: a quality improvement experience from a NICU of a developing country
| Autor: | Khalil Ahmad, Uzair Ansari, Vikram Kumar, Arjumand Rizvi, Simon Demas, Kashif Hussain, Shabina Ariff, Syed Rehan Ali, Ali Shabbir Hussain, Syed Shamim Raza, Waqar Khowaja, Uswa Jiwani, Gul Ambreen |
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| Rok vydání: | 2021 |
| Předmět: |
Parenteral Nutrition
medicine.medical_specialty Pediatrics Neonatal intensive care unit 030309 nutrition & dietetics Weight Gain Sepsis 03 medical and health sciences 0302 clinical medicine Intensive Care Units Neonatal medicine Humans 030212 general & internal medicine Neonatology Developing Countries Retrospective Studies 0303 health sciences business.industry Infant Newborn Outcome measures medicine.disease Quality Improvement Parenteral nutrition Pediatrics Perinatology and Child Health medicine.symptom business Weight gain Hospital stay |
| Zdroj: | Archives of Disease in Childhood. 107:381-386 |
| ISSN: | 1468-2044 0003-9888 |
| DOI: | 10.1136/archdischild-2021-321552 |
| Popis: | ObjectiveNutrition societies recommend using standardised parenteral nutrition (SPN) solutions. We designed evidence-based SPN formulations for neonates admitted to our neonatal intensive care unit (NICU) and evaluated their outcomes.DesignThis was a quality improvement initiative. Data were collected retrospectively before and after the intervention.SettingA tertiary-care level 3 NICU at the Aga Khan University in Karachi, Pakistan.PatientsAll NICU patients who received individualised PN (IPN) from December 2016 to August 2017 and SPN from October 2017 to June 2018.InterventionsA team of neonatologists and nutrition pharmacists collaborated to design two evidence-based SPN solutions for preterm neonates admitted to the NICU.Main outcome measuresWe recorded mean weight gain velocity from days 7 to 14 of life. The other outcomes were change in weight expressed as z-scores, metabolic abnormalities, PN-associated liver disease (PNALD), length of NICU stay and episodes of sepsis during hospital stay.ResultsNeonates on SPN had greater rate of change in weight compared with IPN (β=13.40, 95% CI: 12.02 to 14.79) and a smaller decrease in z-scores (pConclusionsWe found that SPN was associated with shorter NICU stay and greater weight gain. In-house preparation of SPN can be used to address the nutritional needs in resource-limited settings where commercially prepared SPN is not available. |
| Databáze: | OpenAIRE |
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