Lapillonne Alexandre, Fellous Laure, Mokthari M, Kermorvant-Duchemin Elsa
APHP, Department of Neonatology and Nutrition, Saint Vincent de Paul Hospital, 82 avenue Denfert Rochereau, Paris 75014, France.
J Pediatr Gastroenterol Nutr. 2009 May;48(5):618-26. doi: 10.1097/MPG.0b013e31818c52bc.
The aim of the study was to evaluate parenteral nutrition objectives for very low birth weight (VLBW) infants in neonatal intensive care units (NICUs), and to compare nutritional protocol differences according to levels of care.
A national survey was conducted in France through a questionnaire sent to 296 French neonatal departments to determine each team leader's nutritional objectives for parenteral nutrition of VLBW infants.
A total of 172 of the 296 French neonatal departments responded to the questionnaire. Protein administration was not started during the first day of life in half of the responding units. Furthermore, half of the units initiated protein administration with less than 1 g x kg(-1) x day(-1). The day of introduction of lipid emulsions varied considerably from one unit to another, but more than half of the units started the lipid emulsions after the third day of life. Twenty percent of the units reported a target energy intake of 100 kcal x kg(-1) x day(-1), whereas 14% reported a target intake above or equal to 130 kcal x kg(-1) x day(-1).
In comparison with recent guidelines for parenteral nutrition for VLBW infants, the results indicate that the majority of the departments are familiar with target macronutrient and energy intakes, but the time of introduction and the rate of progression of macronutrients, particularly proteins and lipids, are frequently lower than those defined by the guidelines. The large-scale publication of new nutritional guidelines for the parenteral nutrition of neonates and preterm infants as well as regular, specific training in the parenteral nutrition of preterm infants are needed.
本研究旨在评估新生儿重症监护病房（NICU）中极低出生体重（VLBW）婴儿的肠外营养目标，并根据护理水平比较营养方案的差异。
在法国进行了一项全国性调查，通过向296个法国新生儿科室发送问卷，以确定每个团队负责人对VLBW婴儿肠外营养的营养目标。
296个法国新生儿科室中有172个回复了问卷。在一半的回复单位中，出生第一天未开始给予蛋白质。此外，一半的单位开始给予蛋白质时的剂量低于1 g·kg⁻¹·d⁻¹。不同单位引入脂质乳剂的时间差异很大，但超过一半的单位在出生第三天后开始使用脂质乳剂。20%的单位报告目标能量摄入量为100 kcal·kg⁻¹·d⁻¹，而14%的单位报告目标摄入量高于或等于130 kcal·kg⁻¹·d⁻¹。
与近期VLBW婴儿肠外营养指南相比，结果表明大多数科室熟悉目标宏量营养素和能量摄入量，但宏量营养素，特别是蛋白质和脂质的引入时间和进展速度通常低于指南所定义的水平。需要大规模发布新生儿和早产儿肠外营养的新营养指南，以及对早产儿肠外营养进行定期、专门的培训。
