Total Parenteral Nutrition (TPN) and Growth in Very Low Birth Weight (VLBW) Infants in a Public Hospital in Argentina ♦ 1537

Abstract

Survival of VLBW infants has been steadily improving in Argentina. During the 80's few institutions systematically used TPN due to the unavailability of pharmacy prepared solutions. In the 90's TPN was made commercially available to many hospitals. In the University Hospital in Buenos Aires TPN has been systematically used from 1/1/95 (90 kcal/kg; Aminoacids:3 gr./kg Trophamine®; Lipids 3gr./ kg @ 20%). The present study compares growth of VLBW infants on TPN with intrauterine standard growth curves. These curves may not be ideal for comparison, but they still represent a possibly desirable maximum goal. All infants with birth weight ≤ 1500gr. on TPN as the sole source of calories after day 7 of life, from 6/1/95 though 6/30/97, were included in the study. Infants with chromosomal anomalies were excluded. For each infant, weekly weight gain (postnatal weeks 2, 3 and 4) was compared to the intrauterine expected weight gain for equivalent gestational age. Infants were removed from the study when oral feeds were successfully introduced. Twenty three NB were included (BW:1128 gr; 760 gr - 1450 gr, 40% SGA; 91% IMV; 52% received surfactant). Of these, 14 received 2 weeks of only TPN and 9,≥ 3 weeks. Mean days to recover birth weight were 17. No infant died during the study. Infants achieved a steady increase in weight with an average of 70 gr./week (37% of expected intrauterine growth). Table. These data show sustained weight gain in VLBW infants on TPN as sole source of calories. Although weight gain was poor compared to intrauterine standards, the data obtained represent a starting point in the evaluation of nutritional regimes in infants who cannot tolerate oral feeds.