Standardized parenteral nutrition in preterm infants: early impact on fluid and electrolyte balance.
BACKGROUND
Parenteral nutrition is commonly given to premature infants. It has previously been suggested that standardized parenteral nutrition (SPN) may offer nutritional advantages compared to individualized parenteral nutrition (IPN). However, whether the same level of biochemical control is assured with SPN and with IPN remains uncertain.


OBJECTIVE
To compare fluid and electrolyte balance in preterm infants receiving IPN versus SPN in the first week of life.


METHODS
107 infants born at <33 weeks gestation were prospectively evaluated. Serum and urinary creatinine and electrolyte concentration, urine volume, body weight, fluid, electrolyte and energy intakes were recorded daily.


RESULTS
40 infants received IPN and 67 SPN. Infants in IPN had significantly more water and less sodium intake than those receiving SPN. Energy and amino acid intakes were significantly lower in IPN than in SPN groups. Incidence of hypernatremia and hyponatremia was similar in both groups. Nonoliguric hyperkalemia (NOHK) was significantly more frequent in IPN than in SPN (20.0 vs. 2.9%) and mean serum K(+) peak over the first 3 days was higher in IPN than in SPN (5.63 +/- 1.05 vs. 4.91 +/- 0.78 mmol/l). Weight loss (% of birth weight) at day 7 was significantly higher in IPN than in SPN (7.7 +/- 5.8 vs. 4.2 +/- 6.5) without differences in urine output/input fluid intake ratio and glomerular renal function between the two groups.


CONCLUSIONS
There were no significant differences in water and sodium balance in preterm infants who received IPN versus SPN. The risk of NOHK was higher in IPN. Also, SPN significantly increased amino acid and caloric intakes, and it reduced early weight loss.
Iacobelli
Silvia
S
Neonatal Intensive Care Unit, Department of Paediatrics, University of Dijon, Dijon, France. sylvia.iacobelli @ chu-dijon.fr
Bonsante
Francesco
F
Vintéjoux
Amélie
A
Gouyon
Jean-Bernard
JB
D001835:Body Weight; D003404:Creatinine / Q000097:blood / Q000652:urine; D004326:Drinking; D004573:Electrolytes / Q000097:blood / Q000652:urine; D002149:Energy Intake; D005260:Female; D006801:Humans; D006947:Hyperkalemia / Q000517:prevention & control; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010288:Parenteral Nutrition / Q000592:standards*; D011188:Potassium / Q000097:blood / Q000652:urine; D012964:Sodium / Q000097:blood / Q000652:urine; D012982:Sodium, Dietary / Q000008:administration & dosage / Q000592:standards; D014882:Water-Electrolyte Balance; D015431:Weight Loss
D004573:Electrolytes; D012982:Sodium, Dietary; D012964:Sodium; D003404:Creatinine; D011188:Potassium