PARENTERAL NUTRITION IN VERY LOW BIRTH WEIGHT INFANTS. WHEN TO START?

Maria Amenaide Carvalho Alves de Sousa, Ana Suely Vieira, Suely Ribeiro, Lícia Maria Oliveira Moreira

Abstract


Objective: To assess the effects of parenteral nutrition (PN) initiation time in very low birth weight neonates on: the birth weight recovery time, enteral nutrition (EN) initiation time, duration of hospitalization, and incidence of death. Methods: This retrospective case-control study was performed in the neonatal intensive care unit (NICU) of a tertiary center: Santo Amaro Hospital, Salvador, Brazil. All infants with birth weights ≤ 1500 g who were treated in the NICU during the study period (n= 114) were included. The sample was divided in two groups: early (≤ 48 h after birth) and late (> 48 h after birth) onset of PN. We also analyzed a subgroup of neonates with birth weights ≤ 750g, as well as a group for whom PN was initiated very early (≤ 24 h after birth). Results: A total of 114 neonates (n=48 / 39.8% in early PN group),were included in the study.  Birth weight recovery time (9.9 ± 4.0 vs 12.8 ± 6.1, p = 0.007), lenght of hospitalization (43.2 ± 4.0 vs 71.8 ± 41.7, p = 0.007), and time of EN onset (2.2 ± 1.2 vs 7.9 ± 5.8, p <0.001) , were significantly lower in the early PN onset group than in the late onset group. Lenght of hospitalization was positively correlated with the timing of EN onset (r= 0,37, p = 0,001). No significant difference in adverse outcomes: death (18.6% vs 13.6%, p = 0.6), intracranial hemorrhage (ICH) (8.3% vs 12.1%, p = 0.9 ) and patent ductus arteriosus (PDA) (8.3% vs 31.8%, p = 0.1) was obbserved between groups. Conclusion: In this study, the early initiation of nutritional support in very low birth weight neonates can reduce the length of hospitalization thereby reducing costs, without increasing the incidence of adverse effects.


Keywords


Very low birth weight; Premature infant; Parenteral nutrition; Enteral nutrition.

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DOI: http://dx.doi.org/10.17267/2317-3386bjmhh.v1i1.106

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Brazilian Journal of Medicine and Human Health | ISSN: 2317-3386

Updated 03/16/17

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