Introducing total parenteral nutrition in a neonatal care unit - abstract

ABSTRACT

From October 1985 to November 1987, 150 out of 845 newborns hospitalized in the Pointe-a-Pitre Hospital Neonatal Care Unit have received total parenteral nutrition (TPN). Two hundred and four catheterizations have been performed on 150 newborns, 74 per cent less than 2,000 gm birth weight. Sixty-one per cent of the latter were less than 32 weeks of gestation. Indications for TPN were as follows 66 (44 per cent)less than 1,500 gm birth weight (6 with necrotizing enterocolitis), 84 (56 per cent) 1,500 gm or more birth weight, 47 with pre-existing perpartum distress, 22 with gastrointestinal disorders, 11 with necrotizing enterocolitis and 4 with gastrointestinal congenital malformations. On average, central venous catheterization was performed on the eighth day of life, and infusion time was 25 days. The commonly observed TPN complications are glucose intolerance, hepatic cholestasis and phosphocalcific metabolism disorders (osteoporosis, ricketts). A clear-cut distinction is made between an introductory phase of the technique (1985-1986), and a second phase where better prevention of complications was achieved (1986-1987). TPN has become a necessary alternative for the management of newborns at high risk with gastrointestinal problems. In our patients, it has produced an average daily weight gain of 21 gm (AU)