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Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants

Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcom...

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Autores principales: Morris, Erin E., Miller, Neely C., Marka, Nicholas A., Super, Jennifer L., Nagel, Emily M., Gonzalez, Juan David, Demerath, Ellen W., Ramel, Sara E.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570539/
https://www.ncbi.nlm.nih.gov/pubmed/36235546
http://dx.doi.org/10.3390/nu14193890
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author Morris, Erin E.
Miller, Neely C.
Marka, Nicholas A.
Super, Jennifer L.
Nagel, Emily M.
Gonzalez, Juan David
Demerath, Ellen W.
Ramel, Sara E.
author_facet Morris, Erin E.
Miller, Neely C.
Marka, Nicholas A.
Super, Jennifer L.
Nagel, Emily M.
Gonzalez, Juan David
Demerath, Ellen W.
Ramel, Sara E.
author_sort Morris, Erin E.
collection PubMed
description Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). Enhanced early PN was not associated with improved neurodevelopment; however, first-week enteral caloric and protein intake were associated with improved speed of processing.
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spelling pubmed-95705392022-10-17 Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants Morris, Erin E. Miller, Neely C. Marka, Nicholas A. Super, Jennifer L. Nagel, Emily M. Gonzalez, Juan David Demerath, Ellen W. Ramel, Sara E. Nutrients Article Retrospective studies indicate that the parenteral provision of calories, proteins, and lipids in the first week of life is associated with improved later neurodevelopment. We aimed to determine whether infants randomized to an enhanced parenteral nutrition protocol had improved developmental outcomes at 4, 12, or 24 months corrected age (CA). In total, 90 preterm infants (<32 weeks gestational age and <1500 g) were randomized to receive enhanced parenteral nutrition (PN) or standard PN during the first week of life. The enhanced group received a higher glucose infusion rate and intralipids. Neurodevelopmental outcomes included pattern-reversal visually evoked potentials (VEP) at 4 months CA (n = 33) and the Bayley Scales of Infant Development (BSID) at 12 (n = 46) and 24 (n = 29) months CA. P100 latency was longer in the intervention group, indicating slower processing speed (145 vs. 178 ms, p = 0.01). This association did not hold in multivariable analysis adjusting for potentially confounding variables. BSID scores were not associated with enhanced PN. Higher enteral energy and protein intake regardless of randomization group were associated with faster processing speed at 4 months CA (p ≤ 0.02 for both). Enhanced early PN was not associated with improved neurodevelopment; however, first-week enteral caloric and protein intake were associated with improved speed of processing. MDPI 2022-09-20 /pmc/articles/PMC9570539/ /pubmed/36235546 http://dx.doi.org/10.3390/nu14193890 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 Article
Morris, Erin E.
Miller, Neely C.
Marka, Nicholas A.
Super, Jennifer L.
Nagel, Emily M.
Gonzalez, Juan David
Demerath, Ellen W.
Ramel, Sara E.
Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title_full Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title_fullStr Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title_full_unstemmed Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title_short Randomized Trial of Early Enhanced Parenteral Nutrition and Later Neurodevelopment in Preterm Infants
title_sort randomized trial of early enhanced parenteral nutrition and later neurodevelopment in preterm infants
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9570539/
https://www.ncbi.nlm.nih.gov/pubmed/36235546
http://dx.doi.org/10.3390/nu14193890
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