Abstract
Background: In preterm infants, it is important to ensure adequate nutritional intake to accomplish foetal growth requirements. This study evaluated clinical practice regarding the prescription of parenteral nutrition in preterm infants in the neonatology unit of a tertiary hospital. Methods: It was a retrospective observational study of a sample of preterm infants (n = 155) born between January 2015 and December 2017 who were prescribed parenteral nutrition. Compliance with the hospital’s protocol and with the guidelines of the scientific societies American Society for Parenteral and Enteral Nutrition (ASPEN), European Society for Clinical Nutrition and Metabolism (ESPEN) and Spanish Society of Clinical Nutrition and Metabolism (SENPE) was evaluated. The differences in macronutrient intake and total duration of parenteral nutrition were analysed according to gestational age and birth weight. Results: The established protocol was followed in a high percentage (95.5%–100%) except with respect to the initiation of supplying established trace elements (64.9%). Compliance with the recommendations set forth in the guidelines was between 82.1% and 100%, with the exception of the initial carbohydrate intake recommended by ASPEN and ESPEN, for which compliance was 8.3%. Lower gestational age and birth weight were correlated with longer duration of parenteral nutrition (p < 0.001). Conclusions: A lower gestational age and birth weight are related to a longer duration of parenteral nutrition. The results of this study demonstrate the importance of developing and evaluating protocols in clinical practice.
Highlights
Worldwide, prematurity is the leading cause of mortality in children under 5 years of age [1].It is estimated that 15 million births (11%) occur before 37 weeks of gestation, and the incidence of preterm births is increasing [2]
The preterm population presents a high risk of postnatal malnutrition, and this risk is higher for infants of low gestational age (GA) because nutritional reserves are lower in younger preterm
All preterm infants admitted to the neonatology unit that were prescribed parenteral nutrition (PN) (n = 155), excluding those admitted to this unit who initiated PN in other hospitals, were included in the study
Summary
It is estimated that 15 million births (11%) occur before 37 weeks of gestation, and the incidence of preterm births is increasing [2]. In Europe, annual prematurity rates range from 5.2 to 10.4% [3] and are lower than rates in countries such as the United States (12%) [4]. The incidence of preterm births is increasing, the survival rate of preterm infants, especially in developed countries, has been increasing in recent years due to advances in medical care, among which is the use of nutritional support [4]. The preterm population presents a high risk of postnatal malnutrition, and this risk is higher for infants of low gestational age (GA) because nutritional reserves are lower in younger preterm. This study evaluated clinical practice regarding the prescription of parenteral nutrition in preterm infants in the neonatology unit of a tertiary hospital
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