Appropriate Phosphorus Intake by Parenteral Nutrition Prevents Metabolic Bone Disease of Prematurity in Extremely Low‐Birth‐Weight Infants

Motokura, Kouji; Tomotaki, Seiichi; Hanaoka, Shintaro; Yamauchi, Tamio; Tomotaki, Hiroko; Iwanaga, Kougoro; Niwa, Fusako; Takita, Junko; Kawai, Masahiko

doi:10.1002/jpen.1993

Cited by 5 publications

(2 citation statements)

References 19 publications

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“…It suggests that in the future use of parenteral nutrition for preterm infants, we should focus not only on duration, but also on the timing of the start of application as well as other aspects of details. Meanwhile, a Japanese study found that when preterm infants were given a high-phosphorus intake by parenteral nutritional, it guaranteed a high calcium intake, leading to a decrease in ALP levels in the first month ( 28 ). We suspect that the greater amount and better absorption of calcium and phosphorus in intravenous nutrition compared to oral supplementation might attenuate or delay the occurrence of MBDP.…”

Section: Discussionmentioning

confidence: 99%

Analysis of clinical risk factors for metabolic bone disease of prematurity

Liu,

Wang,

Qian

2024

Front. Pediatr.

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ObjectiveTo analyze clinical data related to preterm infants and identify risk factors for metabolic bone disease of prematurity (MBDP).MethodsThis study involved 856 newborns with a gestational age of less than 37 weeks or a weight of less than 1,500g at the Second Hospital of Jilin University. Multifactorial analysis was performed using logistic regression models to explore the risk factors for MBDP. Linear regression was used to investigate the factors affecting the time of alkaline phosphatase (ALP) exceedance and the peak value of ALP in the MBDP group.ResultsIn the MBDP group, ALP excesses occurred in preterm infants at an average of 39.33 days after birth, and the mean value of peak ALP was 691.41 IU/L. Parenteral nutrition and the application of assisted ventilation were independent risk factors for MBDP, with ORs of 1.02 and 1.03 respectively. Gestational age was found to be a protective factor for earlier time of onset of ALP exceedance (β = 2.24,) and the increase in the peak value of ALP (β = −16.30).ConclusionParenteral nutrition and the application of assisted ventilation are independent risk factors for MBDP. Gestational age is a major factor influencing the time of onset of ALP exceedance and the peak value of ALP in infants with MBDP.

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Section: Discussionmentioning

confidence: 99%

Analysis of clinical risk factors for metabolic bone disease of prematurity

Liu,

Wang,

Qian

2024

Front. Pediatr.

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“…OOP is associated with increased ventilator dependence and fractures in the short term, as well as abnormal bone development and poor growth in the long term. [5][6][7] Such morbidity can indirectly implicate OOP in increasing healthcare costs.…”

Section: Introductionmentioning

confidence: 99%

Reducing Osteopenia of Prematurity-related Fractures in a Level IV NICU: A Quality Improvement Initiative

Cromwell,

Breznak,

Young

et al. 2024

Pediatric Quality &Amp; Safety

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Background: Osteopenia of prematurity (OOP) is often a silent disease in the neonatal intensive care unit (NICU). Despite its association with increased neonatal morbidity, such as fractures, wide variation exists in screening, diagnostic, and management practices. We sought to decrease the rate of OOP-related fractures in our level IV NICU by 20% within 1 year. Methods: A multidisciplinary quality improvement team identified inconsistent screening, diagnosis, and management of OOP, as well as handling of at-risk patients, as primary drivers for OOP-related fractures. Using the model for improvement, we implemented sequential interventions, including screening, diagnosis, and a management algorithm as a “handle-with-care” bundle in infants at risk for fractures. Results: 194 at-risk infants were included, 59 of whom had OOP. There was special cause variation in OOP-related fractures, with a reduction from 0.43 per 1000 patient days to 0.06 per 1000 patient days with our interventions. There was also an improvement in days between fractures from 62 to 337 days. We achieved these improvements despite a similar prevalence of OOP throughout the initiative. We showed special cause variation with increased patients between missed OOP documentation and improved collection of OOP screening laboratories at 4 weeks of life without increased blood testing. Conclusion: A multidisciplinary team approach with standardized OOP screening, diagnosis, and management guidelines, including a handle-with-care bundle, reduces OOP-related fractures in a level IV NICU.

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