Lapillonne A, Fellous L, Kermorvant-Duchemin E
Service de réanimation, néonatologie et nutrition, groupe hospitalier Cochin Saint-Vincent-de-Paul, AP-HP, 84 avenue Denfert-Rochereau, Paris, France.
Arch Pediatr. 2009 Oct;16(10):1329-36. doi: 10.1016/j.arcped.2009.07.015. Epub 2009 Sep 5.
Standard parenteral nutrition solutions have been developed nationwide in France but little is known about their frequency of use and indications.
To evaluate the frequency of the use of standardized parenteral nutrition solutions in neonatal units in France, to determine which solutions are currently available and used, and to determine whether the available parenteral nutrition solutions are satisfactory to the prescriber by evaluating the type and number of additions most frequently prescribed.
National survey performed in France, using a questionnaire sent to 296 French neonatal departments.
Eighty-five percent of level III units and 50% of the level II units responded to the questionnaire. Standardized parenteral nutrition solutions were used in 66% of the responding units and accounted for 45% of the prescriptions of parenteral nutrition in newborns. They were significantly more frequently prescribed by level II than level III units (68% vs. 24%, p<0.0001). Thirteen of the 40 standard solutions declared as solutions for parenteral nutrition did not contain amino acids. The addition of macro- and/or micronutrients was very frequent and often made even if not indicated in the Consumer Medicine Information (CMI).
There is great heterogeneity in parenteral nutrition practices among French neonatal units. A large number of the standard solutions used are not appropriate for the nutrition of full-term and/or preterm infants. Their use in everyday practice does not cover the nutritional needs of the newborn or induces at-risk practices such as supplementation with macro- and/or micronutrients.
法国已在全国范围内开发出标准肠外营养溶液,但对其使用频率和适应症了解甚少。
评估法国新生儿病房使用标准化肠外营养溶液的频率,确定目前可用和正在使用的溶液,通过评估最常开具的添加物类型和数量来确定可用的肠外营养溶液是否令处方医生满意。
在法国进行全国性调查,向296个法国新生儿科室发送问卷。
85%的三级科室和50%的二级科室回复了问卷。66%的回复科室使用了标准化肠外营养溶液,这些溶液占新生儿肠外营养处方的45%。二级科室开具这些溶液的频率显著高于三级科室(68%对24%,p<0.0001)。在宣称用于肠外营养的40种标准溶液中,有13种不含氨基酸。添加大量和/或微量营养素的情况非常频繁,即使在药品说明书中未提及也经常添加。
法国新生儿科室的肠外营养实践存在很大差异。大量使用的标准溶液不适用于足月儿和/或早产儿的营养。其在日常实践中的使用不能满足新生儿的营养需求,或引发如添加大量和/或微量营养素等有风险的做法。