Embleton Nicholas D, Morgan Colin, King Caroline
Newcastle Neonatal Service, Newcastle Hospitals NHS Foundation Trust, Newcastle, UK Institute of Health and Society, Newcastle University, Newcastle, UK.
Neonatal Intensive Care Unit, Liverpool Women's Hospital, Liverpool, UK.
Arch Dis Child Fetal Neonatal Ed. 2015 Jan;100(1):F72-5. doi: 10.1136/archdischild-2013-304061. Epub 2014 Jun 12.
Nutrient intakes in preterm infants are frequently inadequate and are associated with worse neuro-developmental outcome. Preterm infants take time to establish enteral intakes, and parenteral nutrition (PN) is now an integral component of care. Despite this, the evidence base for PN intakes is extremely limited. There remains uncertainty over safe initial and maximum amounts of macronutrients, and the optimal amino acid and lipid composition. Studies have tended to focus on short-term growth measures and there are few studies with long-term follow-up. There may be a tradeoff between improving cognitive outcomes while minimising metabolic harm that means determining the optimal regimen will require long-term follow-up. Given the importance of appropriate nutrition for long-term metabolic and cognitive health, and the associated healthcare costs, optimising the composition of PN deserves to be seen as a research priority in neonatal medicine.
早产儿的营养摄入常常不足，且与较差的神经发育结局相关。早产儿需要时间来建立肠内营养摄入，而肠外营养（PN）现已成为护理的一个重要组成部分。尽管如此，关于PN摄入量的证据基础极其有限。对于宏量营养素的安全初始量和最大量以及最佳氨基酸和脂质组成仍存在不确定性。研究往往侧重于短期生长指标，很少有长期随访研究。在改善认知结局与将代谢损害降至最低之间可能存在权衡，这意味着确定最佳方案需要长期随访。鉴于适当营养对长期代谢和认知健康的重要性以及相关的医疗保健成本，优化PN的组成应被视为新生儿医学的一个研究重点。
