scholarly journals Outcomes in Relation to Early Parenteral Nutrition Use in Preterm Neonates Born between 30 and 33 Weeks Gestation: A Propensity Score Matched Observational Study

2020 ◽  
Author(s):  
James Webbe ◽  
Nicholas Longford ◽  
Cheryl Battersby ◽  
Kayleigh Ougham ◽  
Sabita Uthaya ◽  
...  
Keyword(s):  
Propensity Score ◽  
Observational Study ◽  
Parenteral Nutrition ◽  
Preterm Neonates ◽  
Early Parenteral Nutrition

scholarly journals Outcomes in relation to early parenteral nutrition use in preterm neonates born between 30 and 33 weeks’ gestation: a propensity score matched observational study

2021 ◽  
pp. fetalneonatal-2021-321643 ◽  
Author(s):  
James William Harrison Webbe ◽  
Nicholas Longford ◽  
Cheryl Battersby ◽  
Kayleigh Oughham ◽  
Sabita N Uthaya ◽  
...  
Keyword(s):  
Propensity Score ◽  
Parenteral Nutrition ◽  
Rate Increase ◽  
Late Onset ◽  
Preterm Neonates ◽  
Postnatal Life ◽  
Similar Data ◽  
Absolute Rate ◽  
Randomised Trials ◽  
Early Parenteral Nutrition

ObjectiveTo evaluate whether in preterm neonates parenteral nutrition use in the first 7 postnatal days, compared with no parenteral nutrition use, is associated with differences in survival and other important morbidities. Randomised trials in critically ill older children show that harms, such as nosocomial infection, outweigh benefits of early parenteral nutrition administration; there is a paucity of similar data in neonates.DesignRetrospective cohort study using propensity matching including 35 maternal, infant and organisational factors to minimise bias and confounding.SettingNational, population-level clinical data obtained for all National Health Service neonatal units in England and Wales.PatientsPreterm neonates born between 30+0 and 32+6 weeks+days.InterventionsThe exposure was parenteral nutrition administered in the first 7 days of postnatal life; the comparator was no parenteral nutrition.Main outcome measuresThe primary outcome was survival to discharge from neonatal care. Secondary outcomes comprised the neonatal core outcome set.Results16 292 neonates were compared in propensity score matched analyses. Compared with matched neonates not given parenteral nutrition in the first postnatal week, neonates who received parenteral nutrition had higher survival at discharge (absolute rate increase 0.91%; 95% CI 0.53% to 1.30%), but higher rates of necrotising enterocolitis (absolute rate increase 4.6%), bronchopulmonary dysplasia (absolute rate increase 3.9%), late-onset sepsis (absolute rate increase 1.5%) and need for surgical procedures (absolute rate increase 0.92%).ConclusionsIn neonates born between 30+0 and 32+6 weeks’ gestation, those given parenteral nutrition in the first postnatal week had a higher rate of survival but higher rates of important neonatal morbidities. Clinician equipoise in this area should be resolved by prospective randomised trials.Trial registration numberNCT03767634.

scholarly journals Outcomes following early parenteral nutrition use in preterm neonates: protocol for an observational study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e029065
Author(s):  
James Webbe ◽  
Nicholas Longford ◽  
Sabita Uthaya ◽  
Neena Modi ◽  
Chris Gale
Keyword(s):  
Parenteral Nutrition ◽  
Core Outcome Set ◽  
Preterm Neonates ◽  
Research Database ◽  
Early Introduction ◽  
Registration Number ◽  
Adults And Children ◽  
Preterm Babies ◽  
Early Parenteral Nutrition ◽  
The Uk

IntroductionPreterm babies are among the highest users of parenteral nutrition (PN) of any patient group, but there is wide variation in commencement, duration, and composition of PN and uncertainty around which groups will benefit from early introduction. Recent studies in critically unwell adults and children suggest that harms, specifically increased rates of nosocomial infection, outweigh the benefits of early administration of PN. In this study, we will describe early PN use in neonatal units in England, Wales and Scotland. We will also evaluate if this is associated with differences in important neonatal outcomes in neonates born between 30+0and 32+6weeks+daysgestation.Methods and analysisWe will use routinely collected data from all neonatal units in England, Wales and Scotland, available in the National Neonatal Research Database (NNRD). We will describe clinical practice in relation to any use of PN during the first 7 postnatal days among neonates admitted to neonatal care between 1 January 2012 and 31 December 2017. We will compare outcomes in neonates born between 30+0and 32+6weeks+daysgestation who did or did not receive PN in the first week after birth using a propensity score-matched approach. The primary outcome will be survival to discharge home. Secondary outcomes will include components of the neonatal core outcome set: outcomes identified as important by former patients, parents, clinicians and researchers.Ethics and disseminationWe have obtained UK National Research Ethics Committee approval for this study (Ref: 18/NI/0214). The results of this study will be presented at academic conferences; the UK charity Bliss will aid dissemination to former patients and parents.Trial registration numberNCT03767634

SUN-P024: Early Parenteral Nutrition in Critically Ill Adult Patients: an Observational Study

2017 ◽  
Vol 36 ◽  
pp. S61
Author(s):  
D. Berlana ◽  
L. Santulario ◽  
M. Farre ◽  
L. Betriu ◽  
C. Puiggros ◽  
...  
Keyword(s):  
Observational Study ◽  
Parenteral Nutrition ◽  
Critically Ill ◽  
Adult Patients ◽  
Early Parenteral Nutrition

Immediate Effects of Phototherapy on Sleep of Very Preterm Neonates: An Observational Study

2015 ◽  
Vol 46 (S 01) ◽  
Author(s):  
M. Cremer ◽  
K. Jost ◽  
S. Schulzke ◽  
P. Weber ◽  
A. Datta
Keyword(s):  
Observational Study ◽  
Preterm Neonates ◽  
Very Preterm

scholarly journals The effect of early versus late lipid infusion in parenteral nutrition on the biochemical and cortical auditory evoked potential parameters in preterm neonates

2019 ◽  
Vol 67 (1) ◽  
Author(s):  
Rania Mohamed Abdou ◽  
Hoda Mahmoud Ibrahim Weheiba
Keyword(s):  
Weight Gain ◽  
Parenteral Nutrition ◽  
Biochemical Parameters ◽  
Evoked Potential ◽  
Demographic Data ◽  
Auditory Evoked Potential ◽  
Preterm Neonates ◽  
Lipid Infusion ◽  
Significant Difference ◽  
Cortical Auditory Evoked Potential

Abstract Background As brain activity depends greatly on the functions provided by lipid membranes, dietary fat in early life can affect the developing nervous system. Despite the adoption of an early more aggressive parenteral nutrition approach with amino acid infusions still reluctance to the early use of intravenous lipids in neonates. Aim To compare the effect of delayed versus early introduction of intravenous lipid in preterm on the biochemical parameters and on brain development by the cortical auditory evoked potential (CAEP) latency and amplitude. Methods This is a comparative study included 49 neonates admitted at the ain shams university NICUs. Participants were divided into two groups: 26 in group of early lipid infusion and 23 in late lipid infusion, Demographic data, and biochemical parameters were documented during the 1st 2 weeks of life. The CAEP was performed at age of 6 months. The latency and amplitude of P1 were recorded and compared between both groups. Results In the present work we found that group of early lipid infusion had reach their full oral intake earlier with shorter duration of parenteral nutrition and length of stay. They had better weight gain and significantly better glucose level control than group of late lipid infusion. There was no significant difference in the other chemical parameters between both groups expect for the higher incidence of cholestasis in the group of late lipid infusion. At 6 months of age, the group of early lipid infusion had significantly shorter latency and amplitude of P1 than the group of late lipid infusion. Conclusion Early effective nutrition positively affect feeding tolerance and weight gain and maturation of higher brain centers brain.

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