Does the computer improve the nutritional support of the newborn?

Abstract

Fifty-two consecutlve infants admitted to a regional neonatal unit and requiring parenteral nutrition were randomly allocated to receive feeds based on either a ‘standard bag’ regimen in which the volume of amino acid and dextrose solutions were given in a fixed ratio of 1:3, but with flexible electrolyte addition, or a computer-assisted regimen, taking into account fluid and nutrient composition of partial enteral feeds, additional intravenous fluids and arterial flushes. The aim of the study was to assess whether the computer-generated prescription would reduce parenteral nutrition solution waste, improve electrolyte balance and promote growth when compared with the less flexible ‘standard bag’ approach. There was no difference in wastage of parenteral nutrition solution, biochemical stability (as indicated by plasma sodium or phosphate), or weight gain between the two groups. We conclude that the considerable flexibility afforded by computer-assisted prescribing may be of little benefit to most patients.