European Journal of Pediatrics

, Volume 165, Issue 8, pp 512–518

Assessment of implementation of a standardized parenteral formulation for early nutritional support of very preterm infants

Authors

    • Division of Neonatology, Department of PediatricsPoissy – Saint Germain en Laye Hospital
    • Unité de Réanimation NéonataleCentre Hospitalier Poissy/Saint-Germain-en-Laye
  • Sylvie Crauste-Manciet
    • Pharmacy DepartmentPoissy – Saint Germain en Laye Hospital
    • University of Pharmacy
  • Philippe Narcy
    • Division of Neonatology, Department of PediatricsPoissy – Saint Germain en Laye Hospital
  • Saida Boukhouna
    • Division of Neonatology, Department of PediatricsPoissy – Saint Germain en Laye Hospital
  • Amélie Geffray
    • Pharmacy DepartmentPoissy – Saint Germain en Laye Hospital
  • Marie-Noëlle Guerrault
    • Pharmacy DepartmentPoissy – Saint Germain en Laye Hospital
  • François Bordet
    • Pharmacy DepartmentPoissy – Saint Germain en Laye Hospital
  • Denis Brossard
    • Pharmacy DepartmentPoissy – Saint Germain en Laye Hospital
    • University of Pharmacy
Original Paper

DOI: 10.1007/s00431-006-0124-1

Cite this article as:
Lenclen, R., Crauste-Manciet, S., Narcy, P. et al. Eur J Pediatr (2006) 165: 512. doi:10.1007/s00431-006-0124-1

Abstract

Introduction

Parenteral nutrition (PN) plays an important role in the nutritional support of very preterm newborns. It has been suggested that a high proportion of PN orders could be standardized. In 2002, we implemented in our unit the preparation of three standardized formulations for PN adapted to the nutritional requirements of premature infants <32 weeks. Following this change of practice, a retrospective observational study was conducted to evaluate the relevance of the implemented standardized PN regime. Twenty premature inborn infants <32 weeks gestation who had received standardized (STD) PN in 2003 were matched for 20 infants who had received individualized (IND) PN in 2001. Adequacy of nutrition was assessed by comparing daily intravenous nutrient intake and biochemical parameters during the first week. Amino-acid intakes on day 3 were higher in the STD group (1.5±0.2 g/kg/d vs. 0.9±0.5, p<0.001), and the calcium phosphate intakes were better balanced. The cumulated intake of amino acids for the first week was greater in the STD group (+20% ; p=0.0003). Biochemical parameters were similar in both groups. Insulin infusions were less frequent in the STD group (p<0.06).

Conclusion

Standardized parenteral formulations provided higher early intakes of amino acid and glucose, a better calcium phosphate ratio, and a greater amount of amino-acid intakes during the first week while maintaining the same biochemical parameters. This strategy forms part of an approach concerning quality control and the respect of good professional practice for the preparation of parenteral nutrition solutions.

Keywords

Neonatal parenteral nutritionAmino-acid intakeCalcium phosphate ratioStandardized formulaPremature infants

Copyright information

© Springer-Verlag 2006