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5PSQ-006 Parenteral nutrition in a neonatology intensive care unit: duration and complications
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  1. C Álvarez Asteinza,
  2. ME Gómez Álvarez,
  3. A Arias Martínez,
  4. R Menárguez Blanc,
  5. Á Pieras López,
  6. B Zarate Tamames,
  7. I Maray Mateos,
  8. MD Macía Rivas,
  9. CL Fernández Laguna,
  10. A Lozano Blázquez
  1. Hospital Universitario Central De Asturias, Pharmacy, Oviedo, Spain

Abstract

Background and importance Parenteral nutrition (PN) can be used in any malnourished child or anyone at risk of malnutrition. In preterm newborns, it should be started in the first hours of life, although this artificial technique is not exempt from a series of complications related to its use.

Aim and objectives To analyse the use, prescription time and incidence of complications of PN in a neonatology intensive care unit (ICU).

Material and methods A retrospective descriptive study on the use of PN in the neonatology ICU in our hospital was performed in 2018. Demographic data, birth weight, prescription/reason for suspension, total number of PNs developed, type of nutrition, number of prescription days, metabolic complications (MC) (out of range glucose and triglyceride levels) and electrolytic complications (EC) (out of range ions) were collected from the electronic medical records and PN software.

Results Sixty-one patients (56% male, 44% female) were included in the study: 497 PN were prescribed, all central, and motivated by prematurity (97%), sepsis (1.5%) and oesophageal atresia (1.5%). Causes of cessation were transition to venoclysis (79%), oral nutrition via a nasogastric tube (8%), enteral nutrition via a nasogastric tube (6.5%), death (5%) or loss of central venous line (1.5%).

The number of days PN was given was <3 (n=7), 4–7 (n=21), 8–11 (n=18), 12–15 (n=8) and >15 (n=7). Mean duration in preterm infants by weight was 9.5 days (≤1.5 kg, n=31) and 8 days (>1.5 kg, n=28).

Out of range analytical determinations were observed in 116 cases. The average altered parameters in premature infants according to weight were: 2 (≤1.5 kg) and 0.9 (>1.5 kg). The average alterations according to duration were: 0.5 (≤5 days), 1.5 (5–10 days) and 3 (>10 days).

Alterations were detected in 41 patients (67%); 65.5% only developed EC and 36% only MC. The most frequent were hypernatraemia (31%) in EC and hyperglycaemia (24.5%) in MC (also being the earliest).

Conclusion and relevance The main reason for prescription of PN in neonates was prematurity. The main reason for cessation was a switch to venoclysis. Usage time was slightly longer in those with a lower birth weight. For alterations, the most frequent was hypernatraemia and the earliest hyperglycaemia.

References and/or acknowledgements No conflict of interest.

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