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Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes
Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912377/ https://www.ncbi.nlm.nih.gov/pubmed/35267894 http://dx.doi.org/10.3390/nu14050919 |
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author | Guiducci, Silvia Duci, Miriam Moschino, Laura Meneghelli, Marta Fascetti Leon, Francesco Bonadies, Luca Cavicchiolo, Maria Elena Verlato, Giovanna |
author_facet | Guiducci, Silvia Duci, Miriam Moschino, Laura Meneghelli, Marta Fascetti Leon, Francesco Bonadies, Luca Cavicchiolo, Maria Elena Verlato, Giovanna |
author_sort | Guiducci, Silvia |
collection | PubMed |
description | Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies. |
format | Online Article Text |
id | pubmed-8912377 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-89123772022-03-11 Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes Guiducci, Silvia Duci, Miriam Moschino, Laura Meneghelli, Marta Fascetti Leon, Francesco Bonadies, Luca Cavicchiolo, Maria Elena Verlato, Giovanna Nutrients Review Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies. MDPI 2022-02-22 /pmc/articles/PMC8912377/ /pubmed/35267894 http://dx.doi.org/10.3390/nu14050919 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/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 (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Guiducci, Silvia Duci, Miriam Moschino, Laura Meneghelli, Marta Fascetti Leon, Francesco Bonadies, Luca Cavicchiolo, Maria Elena Verlato, Giovanna Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title | Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title_full | Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title_fullStr | Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title_full_unstemmed | Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title_short | Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes |
title_sort | providing the best parenteral nutrition before and after surgery for nec: macro and micronutrients intakes |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8912377/ https://www.ncbi.nlm.nih.gov/pubmed/35267894 http://dx.doi.org/10.3390/nu14050919 |
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