Pediatr Gastroenterol Hepatol Nutr.
2024 Jul;27(4):246-257. 10.5223/pghn.2024.27.4.246.
Benefits and Risks of Preprepared Parenteral Nutrition for Early Amino Acid Administration in Premature Infants with Very Low Birth Weight
- Affiliations
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- 1Department of Pharmacy, Taipei City Hospital, Taipei City, Taiwan
- 2Institute of Emergency and Critical Care Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- 3Department of Pediatrics, National Taiwan University Hospital, Taipei City, Taiwan
- 4Department of Pediatrics, Neonatal Medical Care Center, Taipei Veterans General Hospital, Taipei City, Taiwan
- 5Department of Pediatrics, School of Medicine, National Yang Ming Chiao Tung University, Taipei City, Taiwan
- 6Department of Education and Research, Taipei City Hospital, Taipei City, Taiwan
- 7Department of Health and Welfare, University of Taipei, Taipei City, Taiwan
- KMID: 2558123
- DOI: http://doi.org/10.5223/pghn.2024.27.4.246
Abstract
- Purpose
Administering early parenteral amino acids to very low birth weight (VLBW) premature infants (birth body weight [BBW]<1,500 g) is challenging due to factors such as holidays, cost, and access to sterile compounding facilities. Using advance-prepared parenteral nutrition (PN) may address this issue and should be evaluated for its safety and potential benefits.
Methods
We extracted data from medical records collected between July 2015 and August 2019. VLBW infants received PN for at least seven days and were split into two groups: the traditional group (n=30), which initially received a glucose solution and then PN on workdays, and the pre-preparation group (n=16), which received advance-prepared PN immediately upon admission to the neonatal intensive care unit.
Results
The median BBWs of the traditional and pre-preparation groups were 1,180.0 vs. 1,210.0 g. In the initial two days, the pre-preparation group had a significantly higher amino acid intake (2.23 and 2.24 g/kg/d) than the traditional group (0 and 1.78 g/kg/d). The pre-preparation group exhibited greater head circumference growth ratio relative to birth (7th day: 1.21% vs. −3.57%, p=0.014; 21st day: 7.71% vs. 3.31%, p=0.017). No significant differences in metabolic tolerance were observed.
Conclusion
Advanced preparation of PN can be safely implemented in VLBW preterm infants, offering advantages such as early, higher amino acid intake and improved head circumference growth within the first 21 days post-birth. This strategy may serve as a viable alternative in settings where immediate provision of sterile compounding facilities is challenging.
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