Aggressive parenteral nutrition in sick very low birth weight babies: A randomized controlled trial

Abstract

Survival of preterm neonates in developing world has improved. Developing countries lag behind in nutritional management in NICU especially parenteral nutrition (PN). This randomized controlled trial was done to evaluate the effect of aggressive parenteral nutrition on nitrogen retention of sick VLBW and extremely low birth weight (ELBW) babies. From September 2009 to February 2010, total 34 babies were randomized to receive aggressive parenteral nutrition (APN)(n=17) or standard parenteral nutrition (SPN) (n=17). The average daily total and PN calory intake of babies in APN group was significantly higher during first week. APN was well-tolerated; however, nitrogen retention was not significantly higher in APN group. Aggressive parenteral nutrition in sick VLBW babies is feasible in developing world, though it did not improve nitrogen retention in first week of life.

Safety and Efficacy of Early High Parenteral Lipid Supplementation in Preterm Infants: A Systematic Review and Meta-Analysis

“…Among these, 6145 studies were excluded after reviewing titles and abstracts, leaving 53 articles for full text review for eligibility ( Figure 1 ). Finally, nine studies were selected with proper eligibility [ 9 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. One study [ 20 ], which was a planned follow-up of a previous RCT [ 19 ], was based on the same population and was therefore considered an identical study.…”

“…One study [ 20 ], which was a planned follow-up of a previous RCT [ 19 ], was based on the same population and was therefore considered an identical study. Therefore, eight publications were included in our final meta-analysis [ 9 , 17 , 18 , 19 , 21 , 22 , 23 , 24 ].…”

“…A meta-analysis that included these two studies showed a significant favorable association of early high IVLE administration (mean difference [MD]: −2.73; 95% confidence interval [CI]: −3.69, −1.78; p < 0.00001; n = 163) ( Figure 3 b), but in two RCTs, the timeline of this outcome was inconsistent. Two studies were excluded, and the time to regain birth weight was reported in the remaining six RCTs [ 9 , 17 , 18 , 21 , 22 , 23 ]. A meta-analysis including these studies discerned no significant differences between the intervention group and control group ( Figure 3 c).…”

“…In a subtotal of six studies [ 9 , 18 , 19 , 22 , 23 , 24 ], the overall mortality was 7.5% (15/201) in the early high IVLE group and 7.1% (14/198) in the control group. None of these studies reported a significant discrepancy in mortality between groups, and meta-analysis supported this finding.…”

Preterm human milk composition and dietary intake of breastfeeding mothers in the Indonesian population

“…Human milk consumption is associated with lower rates of infection, particularly in VP infants and VLBW infants. [2][3][4] However, the high variability of human milk composition makes it difficult for clinicians and researchers to assess the adequacy of nutritional intake of babies. Milk macronutrient contents vary significantly among and within mothers, and can be influenced by various factors, including infant gestational age (GA) and post-natal age.…”