title: Perioperative nutrition in extremely preterm infants undergoing surgical treatment for patent ductus arteriosus is suboptimal.
abstract: OBJECTIVE
  To evaluate perioperative nutrition in extremely preterm infants undergoing surgery for patent ductus arteriosus (PDA).
  
  
  METHODS
  This is a population-based study of extremely preterm infants born in Sweden during 2004-2007 and operated on for PDA. Data on perioperative nutrition were obtained from hospital records. All enteral and parenteral nutrients and blood products were used to calculate daily nutritional intakes, starting 3 days before and ending 3 days after surgery. Data are mean (95% confidence intervals).
  
  
  RESULTS
  Study infants (n = 140) had a mean gestational age (GA) of 24.8 weeks, and mean birth weight was 723 g. Energy and macronutrient intakes were below minimal requirements before, during and after PDA surgery. On the day of surgery, energy intake was 78 (74-81) kcal/kg/day, protein 2.9 (2.7-3.2) g/kg/day, fat 2.5 (2.3-2.7) g/kg/day and carbohydrate intake 10.7 (10.2-11.2) g/kg/day. Nutrition did not vary in relation to GA, but infants operated early (0-6 days after birth) received poorer nutrition than infants operated at older age. Fluid intake was 164 (159-169) mL/kg/day, and it did not vary during the week of surgery.
  
  
  CONCLUSIONS
  Perioperative nutrition in extremely preterm infants undergoing PDA surgery in Sweden is suboptimal and needs to be improved. The significance of malnutrition for outcome after PDA surgery remains unclear and requires further investigation.
authors.affiliation: Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Vera
authors.initials: V
authors.lastname: Westin
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Stoltz Sjöström
authors.forename: Fredrik
authors.initials: F
authors.lastname: Ahlsson
authors.forename: Magnus
authors.initials: M
authors.lastname: Domellöf
authors.forename: Mikael
authors.initials: M
authors.lastname: Norman
mesh_terms: D004374:Ductus Arteriosus, Patent / Q000601:surgery*; D005260:Female; D005502:Food / Q000706:statistics & numerical data; D006801:Humans; D062071:Infant, Extremely Premature; D007231:Infant, Newborn; D008297:Male; D009752:Nutritional Status; D059035:Perioperative Period
keywords: Extremely preterm infants; Macronutrients; Malnutrition; Patent ductus arteriosus; Surgery