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Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits

The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutr...

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Autores principales: Brennan, Ann-Marie, Kiely, Mairead E., Fenton, Sarah, Murphy, Brendan P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852746/
https://www.ncbi.nlm.nih.gov/pubmed/29393903
http://dx.doi.org/10.3390/nu10020170
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author Brennan, Ann-Marie
Kiely, Mairead E.
Fenton, Sarah
Murphy, Brendan P.
author_facet Brennan, Ann-Marie
Kiely, Mairead E.
Fenton, Sarah
Murphy, Brendan P.
author_sort Brennan, Ann-Marie
collection PubMed
description The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase.
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spelling pubmed-58527462018-03-19 Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits Brennan, Ann-Marie Kiely, Mairead E. Fenton, Sarah Murphy, Brendan P. Nutrients Article The optimal composition of standardized parenteral nutrition (SPN) is not yet known, contributing to nutrient deficit accrual and growth failure, with the period of parenteral nutrition weaning, i.e., transition (TN) phase, being identified as particularly vulnerable. We created a comprehensive nutrition database, representative of the nutritional course of a diverse range of preterm infants (n = 59, birth weight ≤ 1500 g, gestation < 34 weeks) by collecting hourly macronutrient intake data as part of a prospective, observational study over 19 months. Using a nutrient modeling technique for the TN phase, various amino acid (AA) concentrations of SPN were tested within the database, whilst acknowledging the nutritional contribution from enteral feeds until target AA intakes were consistently achieved. From the modeling, the AA composition of SPN was determined at 3.5 g/100 mL, which was the maximum to avoid exceeding target intakes at any point in the TN phase. However, in order to consistently achieve target AA intakes, additional nutritional strategies were required, which included increasing the exclusion of enteral feeds in fluid and nutrient calculations from <20 mL/kg/day to <40 mL/kg/day, and earlier fortification of breastmilk at 80 mL/kg/day. This data-driven nutrient modeling process supported the development of an improved SPN regimen for our preterm population in the TN phase. MDPI 2018-02-02 /pmc/articles/PMC5852746/ /pubmed/29393903 http://dx.doi.org/10.3390/nu10020170 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Brennan, Ann-Marie
Kiely, Mairead E.
Fenton, Sarah
Murphy, Brendan P.
Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title_full Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title_fullStr Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title_full_unstemmed Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title_short Standardized Parenteral Nutrition for the Transition Phase in Preterm Infants: A Bag That Fits
title_sort standardized parenteral nutrition for the transition phase in preterm infants: a bag that fits
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5852746/
https://www.ncbi.nlm.nih.gov/pubmed/29393903
http://dx.doi.org/10.3390/nu10020170
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