MODERN EXPERIENCE OF PARENTERAL NUTRITION WITH STANDARDIZED PREPARATIONS OF INDUSTRIAL PRODUCTION IN PEDIATRIC PRACTICE: LITERATURE REVIEW

Abstract

Parenteral nutrition can save the lives of newborns and children who cannot receive adequate oral or enteral nutrition due to premature birth, functional immaturity, intestinal failure or inability to tolerate breastfeeding enterally due to congenital surgical pathology of the gastrointestinal tract, respiratory, cardiovascular and other. Pediatric patients, in particular infants with very low and extremely low birth weight, are particularly vulnerable to energy deficiency and protein restriction, which occurs immediately after birth and / or during periods of serious illness.
 The aim ofthis work. Evaluate the current experience of using standardized drugs for parenteral nutrition in pharmacy and industrial production based on the analysis of the results of international clinical trials and published reviews in this regard.
 Materials and methods. The results of 27 scientific publications were retrospectively analyzed with clear results of clinical randomized observations (case-control studies, prospective cohort studies, time series and retrospective data), multicenter studies, meta-analyzes and systematic reviews of the use of standardized drugs nutrition, industrial production: Numeta G13E, Numeta G16E of the company "Baxter" (USA), etc., also 1 systematic review of the management of "ready-to-use" drugs for parenteral nutrition in newborns. A review of data from scientometric Internet databases: Pub Med, UpToDate, Medscape EU, Medscape Pediatrics, etc.
 Results. According to the literature, parenteral nutrition (PN) can be provided in the form of a standard mixture, currently mainly industrial production, which is designed to cover the nutritional needs of most patients of the same age group (pediatric, including neonatal) with a similar condition.
 Conclusions. Standard solutions for PN can be safely used in most pediatric and neonatal patients, including preterm infants with very low birth weight, usually for the short period of time (up to 2-3 weeks) required by most children. In general, standardized parenteral nutrition should be preferred to individualized solutions in most pediatric patients and infants, including preterm infants with very low birth weight. The ready-to-use standardized industrial product has the potential to reduce the risk of infection, provide a sufficient supply of nutrients, ensure the child's growth within the expected range, is easy to use, reduces prescription errors and potentially reduces economic costs. The short- and long-term impact of its use in subsequent clinical trials should be evaluated.