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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...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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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. |
format | Online Article Text |
id | pubmed-5852746 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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