Standardized versus individualized parenteral nutrition in very low birth weight infants: a comparative study.
BACKGROUND
Parenteral nutrition (PN) improves the growth and outcome of very low birth weight (VLBW) infants. Optimal PN composition, standard (STD-PN) or individualized (IND-PN), is still controversial.


OBJECTIVE
To compare IND-PN and STD-PN as to nutritional and growth parameters, complications and cost.


METHODS
140 VLBW infants were studied. Each of the 70 neonates from the IND-PN group was matched with a neonate of similar gestational age (GA; +/-4 days) on STD-PN. Data collection included demographic, maternal, intrapartum, neonatal, interventional, growth and nutritional data.


RESULTS
Compared to STD-PN infants, IND-PN infants had a significantly lower mean birth weight, greater need for resuscitation at birth and interventions thereafter. Nevertheless, IND-PN infants showed significantly greater weight gain SDS during the 1st week (p = 0.036) and the 1st month of life (p = 0.0004), and higher discharge weight SDS (p = 0.012) and head circumference SDS (p = 0.006). IND-PN infants received higher mean daily caloric intakes. They also had significantly shorter durations of exclusive PN and needed less electrolyte corrections.


CONCLUSIONS
Compared to STD-PN infants, IND-PN infants achieved significantly better growth without added clinical or laboratory complications, had a shorter period of exclusive PN and less electrolyte corrections. IND-PN, in accordance with the current more aggressive nutritional approach, appears optimal for PN of VLBW infants. Yet, STD-PN with adequate composition is an appropriate alternative.
Department of Neonatology, Meyer Children's Hospital, Rambam Health Care Campus, Bat-Galim, Haifa, Israel.
Tatiana
T
Smolkin
Giselle
G
Diab
Irit
I
Shohat
Huda
H
Jubran
Shraga
S
Blazer
Geila S
GS
Rozen
Imad R
IR
Makhoul
D001724:Birth Weight; D053198:Child Nutrition Sciences; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000628:therapy*; D007234:Infant, Premature; D019102:Infant, Very Low Birth Weight; D008297:Male; D010288:Parenteral Nutrition / Q000592:standards*; D012189:Retrospective Studies; D015430:Weight Gain