Achieving parenteral nutrition goals in the critically ill newborns: standardized better than individualized formulations?

AIM

The aim of this paper was to determine if the total parenteral nutrition (PN) goals for newborns in the first two weeks of lifer were better achieved with individualized prescriptions (IND-PN) or standardized formulations STD-PN prescriptions.

METHODS

A retrospective study was conducted in a 16-bed polyvalent pediatric and neonatal intensive care unit in a university hospital, to compare two one-year periods, before and after a move from individualized to standardized formulations. All the prescriptions for newborns who were admitted to our unit on their first day of life and required total PN were evaluated. The primary end-point was the percentage of prescriptions full filling the PN goals defined in the written policy of our unit.

RESULTS

More than 3500 prescriptions were included. The goals of PN were better achieved with STD-PN (44.0% vs. 9.4% of the prescriptions)., even after adjustment for term and birth weight. Differences between groups appeared as early as the third day of PN and remained during the first 15 days of PN.

CONCLUSION

The goals of total PN were better achieved with STD-PN. Perhaps because standardized formulations contain fixed and proportional amounts of nutrients, their use results in less deviation from the established policy.