Paeds Cases · fetal-neonatal-and-perinatal
Parenteral nutrition in neonates — case
Long case and communication station.
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Prompt
A very preterm infant started on early aggressive parenteral nutrition and the pathway to full enteral feeding, with a concerned family.
Case summary
A 780 g male infant is born at 26 weeks' gestation to a 28-year-old primigravida who presented in preterm labour. He is intubated and given surfactant for respiratory distress syndrome, and a umbilical venous catheter is sited at one hour of age. The team asks you to start parenteral nutrition and build the pathway to full enteral feeding. [2] [1]
References6ShowHide
- [1]Koletzko B Guidelines on Paediatric Parenteral Nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), supported by the European Society of Paediatric Research (ESPR). Journal of Pediatric Gastroenterology and Nutrition, 2005.PMID 16254497
- [2]te Braake FW Amino acid administration to premature infants directly after birth. Journal of Pediatrics, 2005.PMID 16227030
- [3]Fivez T Early versus Late Parenteral Nutrition in Critically Ill Children. New England Journal of Medicine, 2016.PMID 26975590
- [4]van Goudoever JB ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Amino acids. Clinical Nutrition, 2018.PMID 30100107
- [5]Hojsak I ESPGHAN position paper: intravenous lipid emulsions and risk of hepatotoxicity. Journal of Pediatric Gastroenterology and Nutrition, 2016.PMID 26825766
- [6]Puder M Parenteral fish oil improves outcomes in patients with parenteral nutrition-associated liver injury. Annals of Surgery, 2009.PMID 19661785