Department of Pediatrics, Ulm University, 89075 Ulm, Germany.
Department of Health Management, Neu-Ulm University of Applied Sciences, 89231 Neu-Ulm, Germany.
Nutrients. 2023 Feb 28;15(5):1224. doi: 10.3390/nu15051224.
The need for high quality evidence is recognized for optimizing practices of parenteral nutrition (PN). The purpose of the present systematic review is to update the available evidence and investigate the effect of standardized PN (SPN) vs. individualized PN (IPN) on protein intake, immediate morbidities, growth, and long-term outcome in preterm infants. A literature search was performed on articles published in the period from 1/2015 to 11/2022 in PubMed and Cochrane database for trials on parenteral nutrition in preterm infants. Three new studies were identified. All new identified trials were nonrandomized observational trials using historical controls. SPN may increase weight and occipital frontal circumference gain and lower the value of maximum weight loss. More recent trials suggest that SPN may easily increase early protein intake. SPN may reduce the sepsis incidence, but overall, no significant effect was found. There was no significant effect of standardization of PN on mortality or stage ≥2 necrotizing enterocolite (NEC) incidence. In conclusion SPN may improve growth through higher nutrient (especially protein) intake and has no effect on sepsis, NEC, mortality, or days of PN.
高质量证据对于优化肠外营养（PN）实践至关重要。本系统评价的目的是更新现有证据，并研究标准化 PN（SPN）与个体化 PN（IPN）对早产儿蛋白质摄入、近期并发症、生长和长期结局的影响。在 PubMed 和 Cochrane 数据库中对 2015 年 1 月至 2022 年 11 月发表的关于早产儿肠外营养的文章进行了文献检索。确定了三项新研究。所有新确定的试验均为使用历史对照的非随机观察性试验。SPN 可能会增加体重和枕额周长的增长，并降低最大体重减轻值。最近的试验表明，SPN 可能会很容易增加早期蛋白质的摄入。SPN 可能会降低败血症的发生率，但总体而言，没有发现显著效果。PN 标准化对死亡率或 2 级及以上坏死性小肠结肠炎（NEC）发生率没有显著影响。总之，SPN 可能通过更高的营养（尤其是蛋白质）摄入来改善生长，并且对败血症、NEC、死亡率或 PN 天数没有影响。
