Negative Outcomes Associated with Medication in Neonates on Parenteral Nutrition Therapy

Abstract

Objective: In Ecuador, studies on clinical daily practice problems focused on parenteral nutrition in neonates are scarce. Therefore, this research aimed to identify negative results associated with medications (NRAM) in neonates with parenteral nutrition (PN) in a third-level hospital in Ecuador. Material and methods: An observational, prospective, descriptive study was designed in the neonatology area of a tertiary-level public hospital, where, for over four months, the medical records, PN prescriptions, and pharmacy-managed databases of 78 patients were analyzed. Drug-related problems (DRPs) as possible causes of NRAM were classified through administrative, physicochemical, and clinical validation. Results: DRPs classified as follows were found: 78.81% by physicochemical, 17.62% by clinical, and 3.57% by administrative validation. The NRAM were 72% quantitatively uncertain, 16% needed, and 11% quantitatively ineffective. Conclusion: The NRAM associated with DRPs were statistically related to prematurity condition, APGAR score, PN time, and the number of medications administered, which suggests the need to create a nutritional therapy committee at the health facility.

Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice

“…Leopoldino et al conducted a longitudinal study in Brazil to assess possible predictors of TRPs in NICU, gestational age, certain medications (alprostadil, antibiotics, and omeprazole) and neurological, cardiac, and renal diseases were risk factors for TRPs in NICUs [ 24 ], but neonates on PN were excluded from the latter study. In a recent prospective study of 78 patients, Diaz et al, identified an association between prematurity, number of medications, parenteral nutrition time and negative results associated with medications [ 25 ]. Our study showed that most neonates are presented with prematurity so we cannot assess this association.…”