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Objective@#To explore the safety and efficacy of intravenous nutrition strategy for preterm infants with birth weight < 1 500 g combined with literatures.@*Methods@#The clinical data of 93 preterm infants with very low or extremely low birth weight (< 1 500 g) who were admitted to the neonatal intensive care unit (NICU) of Liaocheng People's Hospital of Shandong Province from October 2012 to December 2018 were retrospectively analyzed. On the basis of active treatment of primary disease and early enteral nutrition, all preterm infants received "all-in-one" intravenous nutrition strategy. The intravenous nutrient solution containing 6% pediatric compound amino acids, 20% fat emulsion, glucose, vitamins, NaCl, KCl, microelements and minerals was transfused uniformly in 20-24 hours. The changes in growth and biochemical indexes of preterm infants before and after intravenous nutrition intervention were observed. The occurrence of intravenous nutritional complications such as parenteral nutrition associated cholestasis (PNAC) and prognosis were recorded. The receiver operating characteristic (ROC) curve was plotted to assess the predictive power of each indicator for extra uterine growth retardation (EUGR).@*Results@#Ninety-three preterm infants were enrolled in the final analysis. The gestational age was (28.75±1.93) weeks and the birth weight was (1 113.28±190.48) g. All the children except 4 non-surviving preterm infants were discharged from hospital. The average hospitalization time was (51.64±15.98) days. In 89 surviving preterm infants, the maximum weight loss percentage was (4.42±3.12)%, and the time to regain birth weight was (6.36±2.60) days. In these surviving preterm infants, the daily average growth rate of weight gain was (19.53±4.64) g/kg, and the weekly average growth of body length and head circumference gain was (1.06±0.34) cm and (0.69±0.22) cm, respectively. The mean duration of intravenous nutrition was (21.56±8.54) days in 89 surviving preterm infants. The body weight, body length and head circumference of these surviving preterm infants were increased significantly at discharge compared with their admission to NICU [body weight (g): 2 191.63±186.00 vs. 1 118.71±188.78, body length (cm): 45.21±1.50 vs. 37.34±2.56, head circumference (cm): 31.04±1.27 vs. 25.96±1.80]. The level of albumin (Alb) was significantly increased (g/L: 27.52±3.77 vs. 25.70±3.88), however the blood urea nitrogen (BUN) level was significantly reduced (mmol/L: 1.65±1.39 vs. 5.11±3.20) with statistical differences (all P < 0.05). In the 89 surviving preterm infants, 79 preterm infants (88.8%) suffered from premature anemia and 48 (53.9%) achieved transfusion criteria. Forty-two preterm infants (47.2%) had glucose metabolism disorder and 38 (42.7%) had electrolyte disturbances. PNAC occurred in 9 preterm infants (10.1%). Thirty-eight preterm infants (42.7%) had EUGR in weight. ROC curve analysis showed that the combination of gestational age, birth weight and time to restore birth weight had a good predictive value for EUGR in very low or extremely low birth weight preterm infants, and the area under the ROC curve (AUC) was 0.902, the sensitivity was 86.4%, and the specificity was 86.8%.@*Conclusions@#The intravenous nutrition strategy for preterm infants with birth weight < 1 500 g is effective and safe. However, intravenous nutrition can cause some complications, such as glucose metabolism disorder, electrolyte disturbances and PNAC, etc. So the process of intravenous nutrition should be closely monitored. To start EN as early as possible and shorten the duration of intravenous nutrition is an important measure for the prevention of PNAC. The combination of gestational age, birth weight and the time to regain birth weight has a good predictive value for EUGR, and intervention can be strengthened early in hospital to avoid EUGR.
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To explore the safety and efficacy of intravenous nutrition strategy for preterm infants with birth weight < 1 500 g combined with literatures. Methods The clinical data of 93 preterm infants with very low or extremely low birth weight (< 1 500 g) who were admitted to the neonatal intensive care unit (NICU) of Liaocheng People's Hospital of Shandong Province from October 2012 to December 2018 were retrospectively analyzed. On the basis of active treatment of primary disease and early enteral nutrition, all preterm infants received "all-in-one" intravenous nutrition strategy. The intravenous nutrient solution containing 6% pediatric compound amino acids, 20% fat emulsion, glucose, vitamins, NaCl, KCl, microelements and minerals was transfused uniformly in 20-24 hours. The changes in growth and biochemical indexes of preterm infants before and after intravenous nutrition intervention were observed. The occurrence of intravenous nutritional complications such as parenteral nutrition associated cholestasis (PNAC) and prognosis were recorded. The receiver operating characteristic (ROC) curve was plotted to assess the predictive power of each indicator for extra uterine growth retardation (EUGR). Results Ninety-three preterm infants were enrolled in the final analysis. The gestational age was (28.75±1.93) weeks and the birth weight was (1 113.28±190.48) g. All the children except 4 non-surviving preterm infants were discharged from hospital. The average hospitalization time was (51.64±15.98) days. In 89 surviving preterm infants, the maximum weight loss percentage was (4.42±3.12)%, and the time to regain birth weight was (6.36±2.60) days. In these surviving preterm infants, the daily average growth rate of weight gain was (19.53±4.64) g/kg, and the weekly average growth of body length and head circumference gain was (1.06±0.34) cm and (0.69±0.22) cm, respectively. The mean duration of intravenous nutrition was (21.56±8.54) days in 89 surviving preterm infants. The body weight, body length and head circumference of these surviving preterm infants were increased significantly at discharge compared with their admission to NICU [body weight (g): 2 191.63±186.00 vs. 1 118.71±188.78, body length (cm): 45.21±1.50 vs. 37.34±2.56, head circumference (cm): 31.04±1.27 vs. 25.96±1.80]. The level of albumin (Alb) was significantly increased (g/L: 27.52±3.77 vs. 25.70±3.88), however the blood urea nitrogen (BUN) level was significantly reduced (mmol/L: 1.65±1.39 vs. 5.11±3.20) with statistical differences (all P < 0.05). In the 89 surviving preterm infants, 79 preterm infants (88.8%) suffered from premature anemia and 48 (53.9%) achieved transfusion criteria. Forty-two preterm infants (47.2%) had glucose metabolism disorder and 38 (42.7%) had electrolyte disturbances. PNAC occurred in 9 preterm infants (10.1%). Thirty-eight preterm infants (42.7%) had EUGR in weight. ROC curve analysis showed that the combination of gestational age, birth weight and time to restore birth weight had a good predictive value for EUGR in very low or extremely low birth weight preterm infants, and the area under the ROC curve (AUC) was 0.902, the sensitivity was 86.4%, and the specificity was 86.8%. Conclusions The intravenous nutrition strategy for preterm infants with birth weight < 1 500 g is effective and safe. However, intravenous nutrition can cause some complications, such as glucose metabolism disorder, electrolyte disturbances and PNAC, etc. So the process of intravenous nutrition should be closely monitored. To start EN as early as possible and shorten the duration of intravenous nutrition is an important measure for the prevention of PNAC. The combination of gestational age, birth weight and the time to regain birth weight has a good predictive value for EUGR, and intervention can be strengthened early in hospital to avoid EUGR.
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Objective To analyze the clinical application of intravenous nutrition liquid combined with psychological intervention in the treatment of the patients with hyperemesis gravidarum. Methods From July 2014 to March 2017, 162 cases according to the wishes were divided into the control group and the study group, 81 cases in each group. The control group were given nutrient solution by intravenous and the routine nursing, the study group i were received psychological intervention on the basis of the treatment in the control group. The treatment in the two groups were compared. Results The total effective rate was 95.06%(77/81) in the study group, and was 77.78%(63/81) in the control group. The difference in the two groups had statistically significant (P<0.01). The average hospitalization day was (5.3±0.6)d in the study group, while (7.4±0.4)d in the control group, the difference was statistically significant between the two groups(t=6.42, P<0.01). Conclusion Intravenous nutrition combined with psychological intervention in the treatment of hyperemesis gravidarum has good effect, which can effectively improve the clinical treatment effect, and reduce the hospitalization day, and has high clinical application value.
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OBJECTIVE:To explore short-term efficacy and safety of early use of high-dose,medium-dose and low-dose ami-no acid in premature babies. METHODS:99 premature babies were selected and randomly divided into high-dose group,medi-um-dose group and low-dose group,with 33 cases in each group. 3 groups were given Amino acid injection,ivgtt,within 24 h af-ter birth,high-dose group was given 3 g/(kg·d),medium-dose group 2 g/(kg·d)and low-dose group 1 g/(kg·d);those dose in-creased by 0.5 g/(kg·d)day by day;predicted peak values of them were 3.5,3.5 and 3 g/(kg·d),respectively. Treatment courses of 3 groups lasted for 28 d. Health indexes,renal function indexes and blood indexes were observed in 3 groups. The occurrence of complications and ADR were recorded in 3 groups. RESULTS:2 cases withdrew from high-dose and low-dose groups. Hospital-ization stay,the time of body weight increasing to 2 500 g and the rate of body weight decreasing in high-dose group were signifi-cantly lower or shorter than in medium-dose and low-dose groups;the medium-dose group was significantly lower or shorter than the low-dose group,with statistical significance (P<0.05);the levels of creatinine,residual alkali,serum total bilirubin in high-dose group were significantly higher than medium-dose and low-dose groups,and the medium-dose group was significantly higher than the low-dose group,with statistical significance(P<0.05). The number of complications cases in high-dose group(11 cases)were significantly lower than in medium-dose group(20 cases)and low-dose group(26 cases),with statistical significance (P<0.05). No obvious ADR was found in 3 groups. CONCLUSIONS:High-dose of amino acid intravenous nutrition support in early stage can promote the recovery of nutrition state and healthy constitution in premature babies with good tolerance and safety.
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Objective Study of peripherally inserted central catheter (PICC) for low birth weight infant parenteral nutrition effect. Methods A total of 100 low birth weight infants were selected, and then divided into the study group and the control group with 50 cases in each group according to random number table method. The study group used PICC for intravenous nutrition support treatment, the control group using external support for the treatment of indwelling needle for nutrition week vein. Comparing the two groups of one-time success rate of catheterization, average operation time, indwelling time, incidence of complications and nutritional support before and after the treatment, the children of weight. Results The one-time success rate of catheterization between the two groups had no significant difference (P >0.05). The operation time and the indwelling time in the study group was(30.65±9.87) d, (23.47±6.38) d respectively, while in the control group was (3.26±1.09) d, (4.15±1.52) d respectively, the difference was significant between the two groups (t=19.054 and 20.829, P 0.05). Conclusions Parenteral nutritional support by PICC for low birth weight infant is a more ideal way with longer indwelling time and fewer complications.
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Objective To study the role of early intravenous nutrition given aggressively combined with early minimal feeding on very low birth weight infants (VLBWI),and to evaluate the clinical value of intestinal barrier protein and MicroRNA.Methods All of 62 cases of VLBWI admitted in NICU,the Maternal and Child Health Hospital of Nantong Affiliated to Nantong University from January 2006 to June 2014 were recruited.Sixty-two VLBWI were randomly divided into group A and group B.Thirty infants in group A were exposed to conventional intravenous nutrition.Thirty-two infants in group B were treated with early intravenous nutrition aggressively combined with early minimal feeding.The time of birth weight recovery,days with intravenous nutrition,hospital stay and complications were recorded.The liver and kidney functions,electrolytes,blood gas analysis were monitored.Enzyme-linked immunosorbent method was used to detect intestinal fatty acid binding protein (Ⅰ-FABP),an intestinal barrier protein in plasma.Infection related MicroRNA155 was detected with fluorescent quantitative polymerase chain reaction (RT-PCR).Results Group B was superior to group A in weight loss after birth [(13.70 ± 3.10) ％ vs (5.46 ± 2.64) ％,P ＜ 0.05],shorter recovery time of body weight [(12.20 ± 3.38) d vs (6.82 ± 3.20) d,P ＜ 0.05],fewer days with intravenous nutrition [(29.62 ± 4.16) d vs (20.80 ± 3.20) d,P ＜ 0.05] and shorter hospital stays [(44.60 ± 6.32) d vs (28.91 ± 4.36) d,P ＜ 0.05].Compared with group A,the infants in group B had less complications,including hyperbilirubinemia (31.2％ vs 56.7％),extrauterine growth retardation (34.3％ vs 73.3％),cholestasis (6.2％ vs 23.3％),feeding intolerance (15.6％ vs 53.3％) and necrotizing enterocolitis (0 vs 16.7％) (all P ＜ 0.05).Although Ⅰ-FABP had a higher plasma concentration in group A than that of group B [(9.083 ± 1.059) μg/L vs (7.563 ± 0.739) μg/L],the difference was not significant (t =1.190,P =0.076 4).However,the plasma levels of Ⅰ-FABP in infants with necrotizing enterocolitis were significantly higher than those of group B [(19.500 ± 3.510) μg/L vs (7.563 ±0.739) μg/L,t =5.231,P =0.035 0].The expression of MicroRNA155 in group A was markedly higher than that of group B (2-△△ct were 0.81 ± 0.12 and 0.24 ± 0.08,respectively,P ＜ 0.05).Conclusions Giving aggressive intravenous nutrition early combined with early minimal feeding was safety and effective to VLBWI,which was of benefit to their growth and development,reducing complications and shorting hospital stays.The detection of intestinal barrier protein Ⅰ-FABP and MicroRNA155 is useful for monitoring feeding complications of VLBWI.
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In recent years,premature nutritional problems is newborn pediatric paramount concenrn problem.For three material(glucose,protein and fat)metabolism and utilization.premature infants has its own characteristics.In order to avoid side effect,classic parenteral nutrition plan provide for fat emulsion and amino acid gradually,but make premature infants in poor nutrition state.Recent clinical studies have shown that early nutrition is particularly important.Premature infants bom in 24 hours has been given full amount vein nutrition could provide good basis of energy.and avoid associated complications.
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Objective: To explore the influence of lipid emulsion of early intravenous nutrition on gain in weight and observe the side effect in very low birth weight(VLBW) infants.Methods: The infants with birth weight below 1 500 g were randomly divided into the treatment group and the control group.The treatment group received intravenous nutrition with fat emulsion within 24 hours after birth,and the control group received intravenous nutrition without fat emulsion.The weight,biochemical parameters and complication were observed after 10 days.Results:The daily weight gain of treatment group was significantly higher than the cotrol group.The risks of azotemia,high bilirubin and cholestasis were not increased in treatment group.The incidences of complication between the two groups showed no significant difference(P>0.05).Conclusion: The use of fat emulsion in early intravenous nutrition can shorten the average hospital stay,promote the weight gain,and is safe.
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Objective To explore the role of intravenous nutrition and enteral nutrition in the treatment of gastroplegia after gastrectomy. Methods The clinical data of 63 cases of gastroplegia after gastrectomy were retrospectively analyzed. Among the 63 cases, 30 were treated by gastrodynamic drugs and intravenous nutrition(intravenous nutrition group), and the other 33 cases were treated by gastrodynamic drugs and enteral nutrition(enteral nutrition group). Gastrointestinal decompression amount and recovery time of gastroplegia between the two groups were compared. Results Enteral nutrition group had a short recovery time of gastroplegia and less gastrointestinal decompression amount compared with intravenous nutrition group(P
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Objectives:To observe the role of combined use of early micro feeding and intravenous nutrition in low birth weight(LBW) infants. Methods:Fifty four cases of LBW infants were randomly divided into two groups.Early micro feeding and intravenous nutrition were given in one group(EF & IN group) and another group(Control group) was given only with intravenous nutrition.The times of intravenous nutritional support requirement and hospital stay,the increase in body weight and the changes in serum bilirubin,lipids and creatinine were compared between the two groups. Results:The times of intravenous nutritional support and hospital stay were shortened and the body weight was increased in EF & IN group. The levels of serum bilirubin and creatinine and the serial concentrations of lipids on the day 7 and 14 after birth were significantly lower than those in control group. Conclusions:The combination of early,micro feeding and intravenous nutrition is superior to the only use of intravenous nutrition in shortrenning the critical course,increasing the body weight,beginning the oral intake and decreasing the possible injuries from total parenteral nutrition.
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1:1,and fat emulsion's energy delivery exceeding 50% of total non -protein calories.CONCLUSION: It' s high time to set up a parenteral nutrition support team, enabling clinical pharmacists to assist physicians with the regulation of PN support in parenteral nutrition dispensing.