Early versus Late Parenteral Nutrition in Very Low Birthweight Neonates A retrospective study from Oman
Journal Title: Sultan Qaboos University Medical Journal - Year 2012, Vol 12, Issue 1
Abstract
Te aim of this study was to compare the biochemical parameters, weight gain, osteopenia and phosphate supplementation in very low birth weight (VLBW) neonates receiving early versus late parenteral nutrition (EPN versus LPN). Methods: A retrospective study was undertaken in the level III Neonatal Intensive Care Unit at Sultan Qaboos University Hospital, Oman: from January 2007 to October 2008 (LPN group, n = 47) and from January 2009 to June 2010 (EPN group, n = 44). Demographic data, anthropometric and laboratory parameters were extracted from the electronic record system. Results: Te mean age of PN initiation was LPN = 47.3 hours versus EPN = 14.3 hours. Biochemical parameters analysed during the frst week of life revealed a reduction in hypernatraemia (12.7% versus 6.8%) and non-oliguric hyperkalemia (12.7% versus 6.8%) in EPN, with no signifcant differences in acidosis and urea levels between the two groups. Hyperglycemia >12 mmol/L in <1000g was higher in EPN. Nutritional parameters in 81 babies who survived/stayed in the unit up to a corrected gestational age (CGA) of 34 weeks (40 in LPN and 41 in EPN), revealed a reduction in metabolic bone disease (osteopenia of prematurity [OOP], 17.5% versus 7.3%) and the need for phosphate supplementation (22.5% versus 7.3%) in the EPN group. Tere was no increase in acidosis or cholestasis. No difference was noted in albumin levels, time to full feeds, time to regain birthweight and mean weight gain per day till 34 weeks corrected CGA. Conclusion: EPN in VLBW newborns is well tolerated and reduces hypernatraemia, non-oliguric hyperkalemia, OOP and the need for phosphate supplementation.
Authors and Affiliations
Amitha R Aroor| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Lalitha Krishnan| Department of Pediatrics Pondicherry Institute of Medical Sciences, Puducherry, India, Zenaida Reyes| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Muhammed Fazallulah| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Masood Ahmed| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Ashfaq A Khan| Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman, Yahya Al-Farsi| Department of Family Medicine & Public Health, College of Medicine & Health Sciences, Muscat, Oman
Keywords
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