Impact of Parenteral Nutrition Guideline Implementation on Growth of Very Low Birth Weight Infants in a Neonatal Intensive Care Unit.

Abstract

BACKGROUND\nIn preterm neonates, parenteral nutrition (PN) is utilized to provide adequate calories and maintain the expected growth rate of a fetus. To optimize growth, our institution implemented comprehensive guidelines for writing PN. This study compared the effect of this change on growth outcomes of very low birth weight (VLBW) infants at 28 days post-natal age (PNA).\n\n\nMETHODS\nNeonates less than 1,250 grams who received PN for greater than 7 days were divided into pre- and post-implementation cohorts based on date of birth. The primary objective was to compare the average weight velocity in g/kg/day of neonates at 28 days PNA. Secondary objectives included identifying the average number of days to regain birthweight and comparing the percent of infants above the 10th percentile for weight for age at 28 days to baseline.\n\n\nRESULTS\nThere were 204 neonates in Cohort 1 (prior to implementation) and 176 neonates in Cohort 2 (after). No difference in weight velocity was identified (12.9 ± 5.2 vs 12.1 ± 4.9 gm/kg/day; P = 0.177). No difference was detected in days to regain birthweight (9.2 ± 4.6 vs 9.9 ± 4.7; P = 0.909) or in the percent of patients above the 10th percentile for weight for age (birth: 85.3% vs 83.5%; P = 0.634, 28 days: 73% vs 64.8%; P = 0.082).\n\n\nCONCLUSION\nNo difference was observed in the weight velocity of very low birth weight neonates less than 1,250 grams at birth when using the implemented guideline for PN writing at our institution. This article is protected by copyright. All rights reserved.