J Korean Soc Neonatol.  2009 Nov;16(2):110-120.

Early Effective Parenteral Nutrition for Preterm Infants

• Lee BS

Abstract

Mimicking fetal nutrition is the goal of early paretneral nutrition (PN) in very low birth weight infants, however the limited metabolic capacity of immature organs raises concern about the toxicity of metabolites to the developing brain. Starting parenteral amino acids from the first day of life, with a rate of 1.0 to 1.5 g/kg/day, is generally recommended to prevent endogenous protein breakdown by maintaining a positive nitrogen balance. A greater of amino acid infusion rate in the range of the fetal transfer rate (3.5-4.0 g/kg/day) is well tolerated during the early days after birth in VLBWI, however the influence on growth and long-term neurodevelopmental outcome remains unknown. Limited data are available from controlled trials regarding the effects of early supplementation with lipid emulsions on neonatal morbidity. Considering the role of long-chain polyunsaturated fatty acids in the neurodevelopment, the choice of an optimal lipid emulsion should be based on the quality as well as the quantity of the lipid contents. Little is known about the clinical benefit of higher rates of glucose infusion by permitting high serum glucose level or co-administration with insulin.

Keyword

Parenteral nutrition; Nutrition; Premature infants; Amino acid; Lipid emulsion; Glucose

MeSH Terms

Amino Acids
Brain
Emulsions
Fatty Acids, Unsaturated
Glucose
Humans
Infant
Infant, Newborn
Infant, Premature
Infant, Very Low Birth Weight
Insulin
Nitrogen
Parenteral Nutrition
Parturition
Amino Acids
Emulsions
Fatty Acids, Unsaturated
Glucose
Insulin
Nitrogen