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4CPS-189 Adequacy of the prescription of parenteral nutrition in neonatology
  1. A Pintado,
  2. C Fernandez Cuerva,
  3. JJ Alcaraz Sanchez,
  4. C Gallego Fernandez,
  5. I Muñoz Castillo
  1. Hospital Regional Universitario Malaga, Farmacia Hospitalaria, Malaga, Spain


Background Nowadays, there is a stronger consensus on the proceedings of nutritional support with parenteral nutrition (PN) in paediatrics and nutritional requirements in order to improve the process quality and the patient’s safety.

Purpose Review the prescriptions of PN to identify the degree of adherence to the available evidence (Clinical Practice Guide SENPE/SEGHNP/SEFH 2017) and propose areas for improvement.

Material and methods Retrospective study of newborn patients who received PN during 2017 in the area of neonatology in our hospital.

Patients divided according to the age ranges established by the guidelines: preterm newborn (RNPT) and term newborns under 1 month (RNAT).

Variables: contributions of macronutrients (aminoacids, glucose, lipids), micronutrients (sodium, potassium, phosphorus, calcium), volume/kg and caloric requirements.

Data collected from PN elaboration program, Nutriwin, treated in Excel.

Results One-hundred and seventy-nine RNPT and 2,429 PNs were prepared and validated. Aminoacids (aa): 96.8% of PNs met the recommended requirements (3–4 g/kg/day). Carbohydrates (CH): 85.4% were adjusted and 13.4% were above the recommendations (6–12 g/kg/day). The limit of CH (16–18 g/kg/day) was not exceeded. Lipids: they did not exceed the maximum limit (3–4 g/kg/day). Sodium (Na) and potassium (K): 82.69% and 93.03% met the recommended requirements respectively (3–5 mEq/kg/day and 2–5 (mEq/kg/day); phosphate (P): 23% within the recommended limits (1.45–2.25 (mM/g/day), 64.47% above; and calcium (Ca): 80.44% within the recommended range (3–4 mEq/kg/day). Recommended volume (140 ml/kg/day): 7.96% on range, 92.04% below. kcal/kg: in 95.5% of patients increased compared to that recommended on the first day (60 kcal/kg/day); and 90% of patients were below the recommended level in the third week (120 kcal/kg/day).

RNAT under 1 month: 24 patients and 248 NPs. aa: 43.54% met the requirements (2.3–3), exceeding 43.14%. HC and lipids: 100% within the limits (16–18 and 3–4 respectively). Na: 71.79% within the recommended range (2–3); K: 66.49% within the recommended range (1.5–3); 33.5% above; P: 39.5% met the recommendations (1–1.5), 24.5% below, 36% above; and Ca: 75.40% on range (2–3). Volume ml/kg: 90.38% lower than recommended (140 ml/kg/day). Energy requirements: 83.33% of patients lower than recommended (110 kcal/kg).

Conclusion We consider an acceptable degree of adequacy to the published recommendations regarding macronutrient inputs and caloric distribution. The energy and water contributions below the mean could be justified by the administration of concomitant enteral nutrition. The contribution of micronutrients is more variable because of the individual situation of each patient.

References and/or acknowledgements No conflict of interest.

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