Background and Importance Standard parenteral nutrition (PN) solutions should generally be used over individualised PN solutions in the majority of paediatric and newborn patients, including very-low-birth-weight premature infants,1 starting as soon as possible and within 8h at the latest.2 In 2021 our Paediatric and Pharmacy Departments designed a standard central PN (CPN) to have ready to use, in order to meet the nutritional needs of most newborn patients in their first day of life.
Aim and Objectives Evaluate the use of the standard first day of life CPN and describe clinical data of patients and the time frame for its start.
Material and Methods Observational, retrospective and longitudinal study conducted between March 2022 and September 2022 in a tertiary hospital. A database was designed to record all prepared CPN, their use and data of patients who received them.
Results 55 CPN were prepared and 32 (58.2%) were administered. 31 newborn required PN and 100% received the standard first day of life CPN, 18 (58.1%) patients were female, the mean gestational age was 28.5 weeks, the mean weight was 1138.2g and 12 (38.7%) were multiple pregnancies. The indication of PN was: 23 (74.2%) preterm infants born <32.0 weeks with birth weight <1500g, 4 (12.9%) preterm babies born >32.0 weeks with <1500g and 4 (12.9%) patients born <32.0 weeks with birth weight >1500g. The mean time to start CPN was 6:01h (range 1:13-22:54h), 26 (83.9%) babies initiated within 8h at the latest and 5 (16.1%) patients after 8h of life (3 due to a lack of central line, 1 lack of 2 ready to use CPN for twins and 1 delayed prescription). 30 patients (96.8%) started trophic feeding with breast milk (maternal or bank) within the first 24h of life.
Conclusion and Relevance Standard first day of life CPN ready to use has considerably reduced the time to start PN in newborn patients. However, CPN was initiated after 8h of life in 5 patients (mostly due to a lack of central line). Standard first day of life CPN met the nutritional requirements of all newborn requiring PN, not needing to produce individually tailored CPN in any case.
References and/or Acknowledgements 1. 2018 ESPGHAN/ESPEN/ESPR/CSPEN guidelines
2. Neonatal parenteral nutrition. NICE guideline 2020
Conflict of Interest No conflict of interest
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