Strategies of parenteral nutrition for premature infants

Abstract

Objective To evaluate the appropriate strategies of parenteral nutrition for premature infants. Methods One hundred and seven preterm babies with birth weights ranging from 1 000-2 500 g received parenteral nutrition within 2 h after birth during June 2015 to January 2016.Lipids, glucose and electrolytes were applied with standard protocol of parenteral nutrition; while the amino acids contents were1.0-1.5 g·kg-1·d-1 in 81 cases (control group) and 2-2.5 g·kg-1·d-1 in 26 cases (study group). The data of demographics, development, laboratory findings and complications were documented. Results There were no significant differences in the baseline data of gestational age, birth weight between two groups (P>0.05). There were also no significant differences in total protein intake and target non-protein calorie intake within the first week after birth and the total calorie intake during the first two weeks between study group and control group (P>0.05). The start of enteral feeding [(3.54±3.18) d vs.(5.64±5.81) d, P=0.02)], the start of total enteral nutrition [(16.50±9.54) d vs. (21.21±15.63) d, P=0.07)], the recovery of birth weight [(7.35±4.55) vs. (9.19±9.50) d, P=0.19)] in study group were earlier than those in control group.The duration of parenteral nutrition [(16.88±8.99) d vs. (22.33±18.10) d, P=0.04], the duration of hospital stay [(20.62±10.41] d vs. (24.22±15.62) d, P=0.18] were shorter and the hospitalization expenses [(21 929.00 ±11 945.42] Yuan vs.(37 499.58±71 146.80) Yuan, P=0.14] were lower in study group than those in control group.The incidence of metabolic acidosis was significantly lower in study group than that in control group (19.23% vs. 45.68%, P=0.02). There were no significant differences in complications of necrotizing enterocolitis, sepsis, extrauterine growth retardation, parenteral nutrition-associated cholestasis, patent ductus arteriosus, respiratory distress syndrome, nosocomial and the duration of artificial ventilation and oxygen therapy between two groups (P>0.05). The incidence of metabolic disorders (hyperglycemia, hypoglycemia, hypocalcemia, hyponatremia, hypokalemia and hypomagnesemia) was similar in two groups (P>0.05). Conclusion Amino acids should be apply to the premature infants within 2 h after birth, and the contents in parenteral nutrition should be >2.0 g·kg-1·d-1. Key words: Parenteral nutrition; Infant, premature; Amino acids