Standardised versus Individualised Parenteral Nutrition. Further Food for Thought.
Parenteral Nutrition may be prescribed as a standard PN (SPN) formulation or as an individualised PN (IPN) formulation. SPN may have advantages in terms of rapid availability, less prescription errors, decreased risk of infection and cost savings but IPN, specifically tailored to an infants needs, may achieve better outcomes in terms of nutrient intake and weight gain. The aim of our study was to determine if VLBW infants in our NICU benefited from receiving IPN over currently available SPN solutions. Our findings were that VLBW infants prescribed IPN received significantly more amino acid (28%), glucose (6%), energy (11%) and calcium (8%) from the aqueous phase of PN than had they received a similar volume of SPN. The benefits were seen over all the days for which PN was administered. In conclusion, IPN was found to offer significant benefits to our VLBW infants. Modifications to currently available SPN would result in better SPN formulations. Our study also supported the recent recommendation to reduce the calcium:phosphate ratio in PN solutions to avoid early hypophosphataemia.
Department of Neonatology, National Maternity Hospital, Holles St, Dublin.
R
R
McCarthy
Department of Biostatistics, School of Public Health, Physiotherapy and Population Science, UCD, Dublin 4.
R
R
Segurado
Department of Neonatology, National Maternity Hospital, Holles St, Dublin.
M
M
Crealey
Department of Neonatology, National Maternity Hospital, Holles St, Dublin.
A
A
Twomey