Objective: To create an electronic instrument in order to analyze the adequacy of the
preterm infants’ nutritional therapy, checking the difference between the
prescribed and the administered diet.Methods: A prospective and observational study on newborns with birthweight ≤1,500g
and/or gestational age ≤32 weeks, without congenital malformations. The
electronic instrument was developed based on Microsoft Excel 2010
spreadsheets and aimed at automatically calculating body weight gain,
calories and macronutrients received daily by each patient from parenteral
nutrition, intravenous hydration and enteral feedings. The weekly means of
each nutrient were used to compare the prescribed and administered
diets.Results: To evaluate the instrument, 60 newborns with a birth weight of 1,289±305 g
and a gestational age of 30±2 weeks were included. Of them, 9.6% had
restricted growth at birth and 55% at discharge. The median length of stay
was 45±17 days. There were significant differences between prescribed and
administered diet for all of the macronutrients and for total calories in
the first three weeks. The lipid was the macronutrient with the greatest
percentage error in the first week of life.Conclusions: The use of a computational routine was important to verify differences
between the prescribed and the administered diet. This analysis is necessary
to minimize calculation errors and to speed up health providers’ decisions
about the nutritional approach, which can contribute to patients’ safety and
to good nutritional practice. Very low birth weight infants are extremely
vulnerable to nutritional deficiencies and any reduction in macronutrients
they receive may be harmful to achieve satisfactory growth.
Considering that the results demonstrate high energy expenditure during the first weeks of life, there is an evident need to provide the best quality of nutrition for each child in the first weeks of life so that preterm infants with or without intrauterine growth restriction can achieve their maximum potential for growth and development.
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