Baxter Healthcare Corporation, Deerfield, IL 60015, USA.
Nutr Clin Pract. 2013 Apr;28(2):242-6. doi: 10.1177/0884533612470463. Epub 2013 Feb 27.
In 2005, the European Society for Clinical Nutrition and Metabolism released guidelines for the use of pediatric parenteral nutrition (PN). The purpose of this study was to compare PN prescribing patterns in preterm infants with current guideline recommendations.
Six neonatologists in Germany conducted observational, retrospective medical chart reviews on preterm infants <28 days postnatal, hospitalized from October 2009 to April 2011. Infants with a complete medical record who received PN for a minimum of 4 days were enrolled. Patient weight and the change in daily amino acids and intravenous fat emulsion (IVFE) doses administered for the first 7 days of life were abstracted. Median data were used to determine quartiles to compare study results with the current guidelines.
Only 30% of patients met current guidelines that recommend all preterm infants receive amino acids on the first day of life. When amino acids were given, the dose was lower than recommended in the current guidelines. The start of IVFE by day 3 of life was given only to 34% of patients despite the guideline recommendation of 100%.
This study identified several gaps between the current guidelines and patient care that should be explored further.
2005 年，欧洲临床营养与代谢学会发布了儿科肠外营养（PN）使用指南。本研究旨在比较早产儿 PN 处方模式与当前指南建议的差异。
德国的 6 名新生儿科医生对 2009 年 10 月至 2011 年 4 月住院的出生后<28 天的早产儿进行了观察性、回顾性病历审查。纳入至少接受 4 天 PN 治疗且病历完整的婴儿。记录患者体重和出生后前 7 天每日氨基酸和静脉内脂肪乳剂（IVFE）剂量的变化。使用中位数数据确定四分位数，以将研究结果与当前指南进行比较。
仅有 30%的患者符合当前指南的建议，即所有早产儿在生命的第一天就应接受氨基酸。当给予氨基酸时，剂量低于当前指南建议的水平。尽管指南建议 100%的患者应在第 3 天开始使用 IVFE，但实际上只有 34%的患者这样做。
本研究发现当前指南与患者护理之间存在一些差距，这些差距应进一步探讨。
