Iatrogenic malnutrition in neonatal intensive care units: Urgent need to modify practice

Authors: Grover, A., Khashu, M., Mukherjee, A. and Kairamkonda, V.

Journal: Journal of Parenteral and Enteral Nutrition

Volume: 32

Issue: 2

Pages: 140-144

ISSN: 0148-6071

DOI: 10.1177/0148607108314373

Abstract:

Background: Extrauterine growth retardation is a major clinical problem in very-low-birth-weight infants. Parenteral nutrition (PN) serves to achieve rapid maximal nutrition in early postnatal life. There is a lack of uniformity with regard to neonatal PN practice. The objective of this study is to ascertain current practice regarding neonatal PN prescription in the early postnatal period in the United Kingdom. Methods: A study questionnaire was e-mailed to neonatal pharmacists serving level 3 and major level 2 units in the United Kingdom between October 2005 and March 2006. Static numerical information regarding glucose, amino acids, and lipid prescription during the first 10 days of life was collected and compared with current recommendations. Results: Fifty-two (81%) units responded to the questionnaire; 4 units were excluded for incomplete data. Twenty-six units (54%) initiated PN on day 1. Full PN was achieved by the median age of 6 days. Twelve units (25%) achieved full PN only by day 7 or later. Maximum median amino acids were 2.9 g/kg/d. Only 13 units (27%) prescribed <3 g/kg/d, and 2 prescribed more than 3.5 g/kg/d. Nineteen units (39%) initiated lipids on day 1. Eleven units (23%) delayed lipids until day 3, and 2 units delayed lipids until day 4. In comparison to the recommended intake of calories and amino acids, the current median prescription would result in a cumulative deficit over the first 10 days of 420 kcal/kg and 11.9 g/kg, respectively. Conclusions: Our study suggests diverse practice with regard to neonatal PN prescription in the United Kingdom. Current neonatal PN practice entails a significant calorie and protein deficit during early postnatal life and warrants further review. © 2008 the American Society for Parenteral and Enteral Nutrition.

Source: Scopus

Iatrogenic malnutrition in neonatal intensive care units: urgent need to modify practice.

Authors: Grover, A., Khashu, M., Mukherjee, A. and Kairamkonda, V.

Journal: JPEN J Parenter Enteral Nutr

Volume: 32

Issue: 2

Pages: 140-144

ISSN: 0148-6071

DOI: 10.1177/0148607108314373

Abstract:

BACKGROUND: Extrauterine growth retardation is a major clinical problem in very-low-birth-weight infants. Parenteral nutrition (PN) serves to achieve rapid maximal nutrition in early postnatal life. There is a lack of uniformity with regard to neonatal PN practice. The objective of this study is to ascertain current practice regarding neonatal PN prescription in the early postnatal period in the United Kingdom. METHODS: A study questionnaire was e-mailed to neonatal pharmacists serving level 3 and major level 2 units in the United Kingdom between October 2005 and March 2006. Static numerical information regarding glucose, amino acids, and lipid prescription during the first 10 days of life was collected and compared with current recommendations. RESULTS: Fifty-two (81%) units responded to the questionnaire; 4 units were excluded for incomplete data. Twenty-six units (54%) initiated PN on day 1. Full PN was achieved by the median age of 6 days. Twelve units (25%) achieved full PN only by day 7 or later. Maximum median amino acids were 2.9 g/kg/d. Only 13 units (27%) prescribed >/=3 g/kg/d, and 2 prescribed more than 3.5 g/kg/d. Nineteen units (39%) initiated lipids on day 1. Eleven units (23%) delayed lipids until day 3, and 2 units delayed lipids until day 4. In comparison to the recommended intake of calories and amino acids, the current median prescription would result in a cumulative deficit over the first 10 days of 420 kcal/kg and 11.9 g/kg, respectively. CONCLUSIONS: Our study suggests diverse practice with regard to neonatal PN prescription in the United Kingdom. Current neonatal PN practice entails a significant calorie and protein deficit during early postnatal life and warrants further review.

Source: PubMed

Preferred by: Minesh Khashu

Iatrogenic malnutrition in neonatal intensive care units: Urgent need to modify practice

Authors: Grover, A., Khashu, M., Mukherjee, A. and Kairamkonda, V.

Journal: JOURNAL OF PARENTERAL AND ENTERAL NUTRITION

Volume: 32

Issue: 2

Pages: 140-144

eISSN: 1941-2444

ISSN: 0148-6071

DOI: 10.1177/0148607108314373

Source: Web of Science (Lite)

Iatrogenic malnutrition in neonatal intensive care units: urgent need to modify practice.

Authors: Grover, A., Khashu, M., Mukherjee, A. and Kairamkonda, V.

Journal: JPEN. Journal of parenteral and enteral nutrition

Volume: 32

Issue: 2

Pages: 140-144

eISSN: 1941-2444

ISSN: 0148-6071

DOI: 10.1177/0148607108314373

Abstract:

Background

Extrauterine growth retardation is a major clinical problem in very-low-birth-weight infants. Parenteral nutrition (PN) serves to achieve rapid maximal nutrition in early postnatal life. There is a lack of uniformity with regard to neonatal PN practice. The objective of this study is to ascertain current practice regarding neonatal PN prescription in the early postnatal period in the United Kingdom.

Methods

A study questionnaire was e-mailed to neonatal pharmacists serving level 3 and major level 2 units in the United Kingdom between October 2005 and March 2006. Static numerical information regarding glucose, amino acids, and lipid prescription during the first 10 days of life was collected and compared with current recommendations.

Results

Fifty-two (81%) units responded to the questionnaire; 4 units were excluded for incomplete data. Twenty-six units (54%) initiated PN on day 1. Full PN was achieved by the median age of 6 days. Twelve units (25%) achieved full PN only by day 7 or later. Maximum median amino acids were 2.9 g/kg/d. Only 13 units (27%) prescribed >/=3 g/kg/d, and 2 prescribed more than 3.5 g/kg/d. Nineteen units (39%) initiated lipids on day 1. Eleven units (23%) delayed lipids until day 3, and 2 units delayed lipids until day 4. In comparison to the recommended intake of calories and amino acids, the current median prescription would result in a cumulative deficit over the first 10 days of 420 kcal/kg and 11.9 g/kg, respectively.

Conclusions

Our study suggests diverse practice with regard to neonatal PN prescription in the United Kingdom. Current neonatal PN practice entails a significant calorie and protein deficit during early postnatal life and warrants further review.

Source: Europe PubMed Central