Abstract
Parenteral nutrition (PN) has become an integral part of clinical management of very low birth weight premature neonates. Traditionally different components of PN are prescribed individually considering requirements of an individual neonate (IPN). More recently, standardised PN formulations (SPN) for preterm neonates have been assessed and may have advantages including better provision of nutrients, less prescription and administration errors, decreased risk of infection, and cost savings. The recent introduction of triple-chamber bag that provides total nutrient admixture for neonates may have additional advantage of decreased risk of contamination and ease of administration.
Highlights
The placenta is the only source of nutrition for growing fetus during the intrauterine life
ClinOleic® 20% lipid emulsion contains a mixture of 80% olive oil and 20% soybean oil and is given as a 24 h infusion piggy-backed to the rest of the parenteral nutrition (PN) solution containing glucose, amino acids, electrolytes and vitamins
Studies have reported that individualised PN (IPN) is associated with a high incidence of medical errors and protocol deviations [47] while standardised PN (SPN) formulations have been associated with significantly less prescription errors in adult patients [48]
Summary
The placenta is the only source of nutrition for growing fetus during the intrauterine life. Nutrients 2013, 5 cessation of the placental supply of nutrients at birth makes these premature neonates vulnerable to nutritional deficiencies unless enteral or parenteral nutrition is established rapidly. In very premature neonates enteral feeding is often established slowly and during this period, nutrients are provided parenterally in the form of parenteral nutrition (PN). Different components of PN for neonates are prescribed individually taking into consideration the biochemical, nutritional and physiological status of the neonate. Very low birth weight (VLBW) neonates have changing physiology and clinical condition during the first few days of life. It is reasonable to think that PN ordered considering unique requirements of a particular newborn infant will be the most appropriate and will give the best possible outcome in terms of biochemical control, nutrient intake and weight gain. Studies have indicated that most premature neonates tolerate mild to moderate variations in nutritional intake and majority of those can be managed with few sets of standard PN solutions [1,2]
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