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标准化肠外营养解决方案改善极早产儿的宏量和微量营养素供应,有利于其生长和代谢组学特征。

Improved Macro- and Micronutrient Supply for Favorable Growth and Metabolomic Profile with Standardized Parenteral Nutrition Solutions for Very Preterm Infants.

机构信息

Institute of Computational Biology, Helmholtz Zentrum München, 85764 Oberschleißheim, Germany.

Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, 2333 AL Leiden, The Netherlands.

出版信息

Nutrients. 2022 Sep 21;14(19):3912. doi: 10.3390/nu14193912.

DOI:10.3390/nu14193912
PMID:36235563
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9572167/
Abstract

Very preterm infants are at high risk for suboptimal nutrition in the first weeks of life leading to insufficient weight gain and complications arising from metabolic imbalances such as insufficient bone mineral accretion. We investigated the use of a novel set of standardized parenteral nutrition (PN; MUC PREPARE) solutions regarding improving nutritional intake, accelerating termination of parenteral feeding, and positively affecting growth in comparison to individually prescribed and compounded PN solutions. We studied the effect of MUC PREPARE on macro- and micronutrient intake, metabolism, and growth in 58 very preterm infants and compared results to a historic reference group of 58 very preterm infants matched for clinical characteristics. Infants receiving MUC PREPARE demonstrated improved macro- and micronutrient intake resulting in balanced electrolyte levels and stable metabolomic profiles. Subsequently, improved energy supply was associated with up to 1.5 weeks earlier termination of parenteral feeding, while simultaneously reaching up to 1.9 times higher weight gain at day 28 in extremely immature infants (<27 GA weeks) as well as overall improved growth at 2 years of age for all infants. The use of the new standardized PN solution MUC PREPARE improved nutritional supply and short- and long-term growth and reduced PN duration in very preterm infants and is considered a superior therapeutic strategy.

摘要

极早产儿在生命的最初几周存在营养不足的高风险,导致体重增加不足和代谢失衡引起的并发症,如骨矿物质积累不足。我们研究了使用一套新的标准化肠外营养(PN;MUC PREPARE)溶液,以改善营养摄入、加速肠外喂养终止,并积极影响生长,与个体化处方和复合 PN 溶液相比。我们研究了 MUC PREPARE 对 58 例极早产儿的宏量和微量营养素摄入、代谢和生长的影响,并将结果与 58 例极早产儿的历史参考组进行了比较,这些早产儿在临床特征上相匹配。接受 MUC PREPARE 的婴儿表现出改善的宏量和微量营养素摄入,导致电解质水平平衡和稳定的代谢组学特征。随后,改善的能量供应与肠外喂养提前终止的时间提前了 1.5 周,同时在极不成熟的婴儿(<27 周 GA)中达到了高达 1.9 倍的体重增加,以及所有婴儿在 2 岁时的整体生长改善。使用新的标准化 PN 溶液 MUC PREPARE 改善了极早产儿的营养供应、短期和长期生长,并缩短了肠外喂养时间,被认为是一种优越的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/c713ce110d36/nutrients-14-03912-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/ebbd0c6bbb19/nutrients-14-03912-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/b6e784c41b50/nutrients-14-03912-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/df8c7c0a73c4/nutrients-14-03912-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/c713ce110d36/nutrients-14-03912-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/ebbd0c6bbb19/nutrients-14-03912-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/b6e784c41b50/nutrients-14-03912-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/df8c7c0a73c4/nutrients-14-03912-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6607/9572167/c713ce110d36/nutrients-14-03912-g004.jpg

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本文引用的文献

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Front Neurosci. 2022 Feb 17;16:830884. doi: 10.3389/fnins.2022.830884. eCollection 2022.
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Scientific Basis and Practical Application of Nutritional Care for Preterm Infants.早产儿营养护理的科学依据与实际应用
World Rev Nutr Diet. 2021;122:XIII-XIV. doi: 10.1159/000514773. Epub 2021 Aug 5.
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Practice of Parenteral Nutrition in Preterm Infants.
标准化肠外营养与中早产儿早期新生儿生长的关系:基于人群的队列研究。
Nutrients. 2024 Apr 26;16(9):1292. doi: 10.3390/nu16091292.
早产儿肠外营养的实践
World Rev Nutr Diet. 2021;122:198-211. doi: 10.1159/000514751. Epub 2021 Aug 5.
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Newborn metabolic vulnerability profile identifies preterm infants at risk for mortality and morbidity.新生儿代谢脆弱性特征可识别出有死亡和发病风险的早产儿。
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BMC Pediatr. 2020 Feb 8;20(1):59. doi: 10.1186/s12887-020-1958-9.
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Characterization of missing values in untargeted MS-based metabolomics data and evaluation of missing data handling strategies.基于非靶向 MS 的代谢组学数据中缺失值的特征描述及缺失数据处理策略的评价。
Metabolomics. 2018 Sep 20;14(10):128. doi: 10.1007/s11306-018-1420-2.
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ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Lipids.欧洲儿科胃肠病、肝病和营养学会/欧洲临床营养和代谢学会/欧洲儿科研究学会/临床营养和代谢学会儿科肠外营养指南:脂质
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