Shielding Parenteral Nutrition From Light Improves Survival Rate in Premature Infants

Chessex, Philippe; Laborie, Sophie; Nasef, Nehad; Mâsse, Benoı̂t; Lavoie, Jean-Claude

doi:10.1177/0148607115606407

Cited by 32 publications

(42 citation statements)

References 41 publications

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“…Some randomized controlled trials demonstrated a decrease in BPD by shielding PN from light, 36 , 37 while a recent one did not confirm this finding 38 . Recent meta‐analysis confirmed that adequate shielding of PN decreases mortality by half in extremely preterm infants 39 . The second possible intervention is to increase the activity of the glutathione antioxidant system.…”

Section: Discussionmentioning

confidence: 99%

Ascorbylperoxide Contaminating Parenteral Nutrition Is Associated With Bronchopulmonary Dysplasia or Death in Extremely Preterm Infants

Mohamed

Elremaly

Rouleau

et al. 2016

J Parenter Enteral Nutr

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Section: Discussionmentioning

confidence: 99%

Ascorbylperoxide Contaminating Parenteral Nutrition Is Associated With Bronchopulmonary Dysplasia or Death in Extremely Preterm Infants

Mohamed

Elremaly

Rouleau

et al. 2016

J Parenter Enteral Nutr

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“…In addition to the concern of cholestasis, fatty acid compositions of some ILE available in the United States do not meet the needs of the neonatal population aside from preventing essential fatty acid deficiency 19 . ‐ 21 Safety concerns, specifically risk of mortality, were reported in a meta‐analysis evaluating effects of not light protecting PN used for preterm infants 22 . Currently, adequate light protection may not be feasible, depending on the circumstances of whether PN is compounded on‐site or at a central location.…”

Section: Question 2: Are There Any Circumstances In Which Pn Is the Omentioning

confidence: 99%

When Is Parenteral Nutrition Appropriate?

Worthington

Balint

Bechtold

et al. 2017

J Parenter Enteral Nutr

180

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Parenteral nutrition (PN) represents one of the most notable achievements of modern medicine, serving as a therapeutic modality for all age groups across the healthcare continuum. PN offers a life-sustaining option when intestinal failure prevents adequate oral or enteral nutrition. However, providing nutrients by vein is an expensive form of nutrition support, and serious adverse events can occur. In an effort to provide clinical guidance regarding PN therapy, the Board of Directors of the American Society for Parenteral and Enteral Nutrition (ASPEN) convened a task force to develop consensus recommendations regarding appropriate PN use. The recommendations contained in this document aim to delineate appropriate PN use and promote clinical benefits while minimizing the risks associated with the therapy. These consensus recommendations build on previous ASPEN clinical guidelines and consensus recommendations for PN safety. They are intended to guide evidence-based decisions regarding appropriate PN use for organizations and individual professionals, including physicians, nurses, dietitians, pharmacists, and other clinicians involved in providing PN. They not only support decisions related to initiating and managing PN but also serve as a guide for developing quality monitoring tools for PN and for identifying areas for further research. Finally, the recommendations contained within the document are also designed to inform decisions made by additional stakeholders, such as policy makers and third-party payers, by providing current perspectives regarding the use of PN in a variety of healthcare settings. (JPEN J Parenter Enteral Nutr. 2017;41:324-377) The etiology-based nutrition diagnoses in adults in clinical practice settings are as follows: Starvation-related malnutrition: Chronic starvation without inflammation (eg, anorexia nervosa). Chronic disease-related malnutrition: Inflammation is chronicand of mild to moderate degree (eg, organ failure, pancreatic cancer, rheumatoid arthritis, sarcopenic obesity). Acute disease or injury-related malnutrition:Inflammation is acute and of severe degree (eg, major infection burns, trauma, closed head injury). 2,3Malnutrition, pediatric: An imbalance between nutrient requirement and intake, resulting in cumulative deficits of energy, protein, or micronutrients that may negatively affect growth, development, and other relevant outcomes. It is recommended that growth charts based on a standard deviation z score system be used to track and assess nutrition status in children. 4,5Nutritionally-at-risk: Consider the individual nutritionally-atrisk if any of the following is present. Nutritionally-At-Risk Adult Summary of RecommendationsThese consensus recommendations are designed to identify best practices, guide day-to-day clinical decisions, reduce variations in practice, and enhance patient safety. They are not intended to supersede the judgment of the healthcare professional based on the circumstances of the individual patient.

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“…However, our findings suggest caution in the introduction of SMOF in PN, waiting for more investigations. A recent meta‐analysis on photo‐protection of PN reported a reduction of the mortality by half in premature infants receiving PN . In clinical routine, an adequate protection against light exposure is very hard to achieve .…”

Section: Discussionmentioning

confidence: 99%

“…The Guinea pig has been frequently used in the last few years as a neonatal animal model of parenteral nutrition, especially for understanding the impact of PN or components of PN or oxidant molecules generated in PN on pulmonary oxidative stress deriving from free radicals or peroxides as well as on alveolarization . Several findings from this model have found a match in premature infants . In addition, its lipid metabolism is close to humans, and for this reason, it is proposed as a suitable model for lipid study …”

Section: Methodsmentioning

confidence: 99%