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Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU

A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online g...

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Autores principales: Pereira-da-Silva, Luis, Virella, Daniel, Fusch, Christoph
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770216/
https://www.ncbi.nlm.nih.gov/pubmed/31450875
http://dx.doi.org/10.3390/nu11091999
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author Pereira-da-Silva, Luis
Virella, Daniel
Fusch, Christoph
author_facet Pereira-da-Silva, Luis
Virella, Daniel
Fusch, Christoph
author_sort Pereira-da-Silva, Luis
collection PubMed
description A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online growth calculator to monitor intra-hospital weight gain, and Intergrowth-21st standards to monitor growth after discharge. Body weight, though largely used, does not inform on body compartment sizes. Mid-upper arm circumference estimates body adiposity and is easy to measure. Body length reflects skeletal growth and fat-free mass, provided it is accurately measured. Head circumference indicates brain growth. Skinfolds estimate reasonably body fat. Weight-to-length ratio, body mass index, and ponderal index can assess body proportionality at birth. These and other derived indices, such as the mid-upper arm circumference to head circumference ratio, could be proxies of body composition but need validation. Low blood urea nitrogen may indicate insufficient protein intake. Prealbumin and retinol binding protein are good markers of current protein status, but they may be affected by non-nutritional factors. The combination of a high serum alkaline phosphatase level and a low serum phosphate level is the best biochemical marker for the early detection of metabolic bone disease.
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spelling pubmed-67702162019-10-30 Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU Pereira-da-Silva, Luis Virella, Daniel Fusch, Christoph Nutrients Review A practical approach for nutritional assessment in preterm infants under intensive care, based on anthropometric measurements and commonly used biochemical markers, is suggested. The choice of anthropometric charts depends on the purpose: Fenton 2013 charts to assess intrauterine growth, an online growth calculator to monitor intra-hospital weight gain, and Intergrowth-21st standards to monitor growth after discharge. Body weight, though largely used, does not inform on body compartment sizes. Mid-upper arm circumference estimates body adiposity and is easy to measure. Body length reflects skeletal growth and fat-free mass, provided it is accurately measured. Head circumference indicates brain growth. Skinfolds estimate reasonably body fat. Weight-to-length ratio, body mass index, and ponderal index can assess body proportionality at birth. These and other derived indices, such as the mid-upper arm circumference to head circumference ratio, could be proxies of body composition but need validation. Low blood urea nitrogen may indicate insufficient protein intake. Prealbumin and retinol binding protein are good markers of current protein status, but they may be affected by non-nutritional factors. The combination of a high serum alkaline phosphatase level and a low serum phosphate level is the best biochemical marker for the early detection of metabolic bone disease. MDPI 2019-08-23 /pmc/articles/PMC6770216/ /pubmed/31450875 http://dx.doi.org/10.3390/nu11091999 Text en © 2019 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 Review
Pereira-da-Silva, Luis
Virella, Daniel
Fusch, Christoph
Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title_full Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title_fullStr Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title_full_unstemmed Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title_short Nutritional Assessment in Preterm Infants: A Practical Approach in the NICU
title_sort nutritional assessment in preterm infants: a practical approach in the nicu
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770216/
https://www.ncbi.nlm.nih.gov/pubmed/31450875
http://dx.doi.org/10.3390/nu11091999
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