scholarly journals Protein Intakes during Weaning from Parenteral Nutrition Drive Growth Gain and Body Composition in Very Low Birth Weight Preterm Infants

Nutrients ◽  
2020 ◽  
Vol 12 (5) ◽  
pp. 1298 ◽  
Author(s):  
Nadia Liotto ◽  
Orsola Amato ◽  
Pasqua Piemontese ◽  
Camilla Menis ◽  
Anna Orsi ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Progressive Increase ◽  
Fat Free Mass ◽  
Weight Growth ◽  
Group 2 ◽  
Parenteral Protein

Weaning from parenteral to enteral nutrition is a critical period to maintain an adequate growth in very low birth weight preterm infants (VLBWI). We evaluated the actual daily nutritional intakes during the transition phase (TP) in VLBWI with adequate and inadequate weight growth velocity (GV ≥ 15 vs. GV < 15 g/kg/day). Fat-free mass (FFM) at term-corrected age (TCA) was compared between groups. Based on actual nutritional intakes of infants with adequate growth, we defined a standardized parenteral nutrition bag (SPB) for the TP. One hundred and six VLBWI were categorized as group 1 (G1): [GV < 15 (n = 56)] and group 2 (G2): [GV ≥ 15 (n = 50)]. The TP was divided into two periods: main parenteral nutritional intakes period (parenteral nutritional intakes >50%) (M-PNI) and main enteral nutritional intakes period (enteral nutritional intakes >50%) (M-ENI). Anthropometric measurements were assessed at discharge and TCA, FFM deposition at TCA. During M-PNI, G2 showed higher enteral protein intake compared to G1 (p = 0.05). During M-ENI, G2 showed higher parenteral protein (p = 0.01) and energy intakes (p < 0.001). A gradual reduction in SPB volume, together with progressive increase in enteral volume, allowed nutritional intakes similar to those of G2. At TCA, G2 had higher FFM compared to G1 (p = 0.04). The reasoned use of SPB could guarantee an adequate protein administration, allowing an adequate growth and higher FFM deposition.

Plasma Phytosterol Half-Life and Levels Are Increased in Very Low Birth Weight Preterm Infants with Parenteral Nutrition-Associated Cholestasis

Lipids ◽  
2018 ◽  
Vol 53 (7) ◽  
pp. 717-725 ◽  
Author(s):  
Alessio Correani ◽  
Azzurra Pignotti ◽  
Luisita Marinelli ◽  
Chiara Biagetti ◽  
Rita D'Ascenzo ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Half Life ◽  
Very Low Birth Weight

Half-life of plasma phytosterols in very low birth weight preterm infants on routine parenteral nutrition with vegetable oil-based lipid emulsions

2018 ◽  
Vol 37 (1) ◽  
pp. 262-269 ◽  
Author(s):  
Daniele Pupillo ◽  
Alessio Correani ◽  
Chiara Biagetti ◽  
Rita D'Ascenzo ◽  
Manuela Simonato ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Vegetable Oil ◽  
Half Life ◽  
Very Low Birth Weight ◽  
Lipid Emulsions

scholarly journals MODERN EXPERIENCE OF PARENTERAL NUTRITION WITH STANDARDIZED PREPARATIONS OF INDUSTRIAL PRODUCTION IN PEDIATRIC PRACTICE: LITERATURE REVIEW

2020 ◽  
Vol 10 (4(38)) ◽  
pp. 69-76
Author(s):  
T. Znamenska ◽  
O. Vorobiova ◽  
Y. Marushko
Keyword(s):  
Clinical Trials ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Parenteral Nutrition ◽  
Preterm Infants ◽  
Industrial Production ◽  
Pediatric Patients ◽  
Very Low Birth Weight ◽  
Extremely Low Birth Weight ◽  
Short Period

Parenteral nutrition can save the lives of newborns and children who cannot receive adequate oral or enteral nutrition due to premature birth, functional immaturity, intestinal failure or inability to tolerate breastfeeding enterally due to congenital surgical pathology of the gastrointestinal tract, respiratory, cardiovascular and other. Pediatric patients, in particular infants with very low and extremely low birth weight, are particularly vulnerable to energy deficiency and protein restriction, which occurs immediately after birth and / or during periods of serious illness. The aim ofthis work. Evaluate the current experience of using standardized drugs for parenteral nutrition in pharmacy and industrial production based on the analysis of the results of international clinical trials and published reviews in this regard. Materials and methods. The results of 27 scientific publications were retrospectively analyzed with clear results of clinical randomized observations (case-control studies, prospective cohort studies, time series and retrospective data), multicenter studies, meta-analyzes and systematic reviews of the use of standardized drugs nutrition, industrial production: Numeta G13E, Numeta G16E of the company "Baxter" (USA), etc., also 1 systematic review of the management of "ready-to-use" drugs for parenteral nutrition in newborns. A review of data from scientometric Internet databases: Pub Med, UpToDate, Medscape EU, Medscape Pediatrics, etc. Results. According to the literature, parenteral nutrition (PN) can be provided in the form of a standard mixture, currently mainly industrial production, which is designed to cover the nutritional needs of most patients of the same age group (pediatric, including neonatal) with a similar condition. Conclusions. Standard solutions for PN can be safely used in most pediatric and neonatal patients, including preterm infants with very low birth weight, usually for the short period of time (up to 2-3 weeks) required by most children. In general, standardized parenteral nutrition should be preferred to individualized solutions in most pediatric patients and infants, including preterm infants with very low birth weight. The ready-to-use standardized industrial product has the potential to reduce the risk of infection, provide a sufficient supply of nutrients, ensure the child's growth within the expected range, is easy to use, reduces prescription errors and potentially reduces economic costs. The short- and long-term impact of its use in subsequent clinical trials should be evaluated.

scholarly journals Targeted Breast Milk Fortification for Very Low Birth Weight (VLBW) Infants: Nutritional Intake, Growth Outcome and Body Composition

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1156 ◽  
Author(s):  
Sumesh Parat ◽  
Praneeta Raza ◽  
May Kamleh ◽  
Dennis Super ◽  
Sharon Groh-Wargo
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Breast Milk ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Protein Intake ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Standard Group ◽  
Low Birth Weight Infants

Despite improvements in nutritional management, preterm infants continue to face high rates of postnatal growth restriction. Because variability in breast milk composition may result in protein and energy deficits, targeted fortification has been advocated. We conducted an interventional study to compare body composition and growth outcomes of very low birth weight infants fed targeted protein-fortified human milk (HM) with those fed standard fortified HM. If mother’s own milk was not available, donor milk was used. Weekly analysis of HM with mid-infrared spectroscopy was conducted and additional protein was added to the fortified HM to ensure a protein intake of 4 g/kg/day. Weekly anthropometric measurements were done. Prior to discharge or at 37 weeks, corrected age skinfold thickness (SFT) measurements as well as body composition measurement using air displacement plethysmography were done. Among 36 preterm infants enrolled, those in the targeted group (n = 17) received more protein and had a larger flank SFT at study end than those in the standard group (n = 19). A pilot post-hoc analysis of subjects having at least 30 intervention days showed a 3% higher fat-free mass in the targeted group. Use of a targeted fortification strategy resulted in a higher protein intake and fat-free mass among those receiving longer intervention.

Greater Early Gains in Fat-Free Mass, but Not Fat Mass, Are Associated with Improved Neurodevelopment at 1 Year Corrected Age for Prematurity in Very Low Birth Weight Preterm Infants

2016 ◽  
Vol 173 ◽  
pp. 108-115 ◽  
Author(s):  
Sara E. Ramel ◽  
Heather L. Gray ◽  
Ellen Christiansen ◽  
Christopher Boys ◽  
Michael K. Georgieff ◽  
...  
Keyword(s):  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Fat Mass ◽  
Very Low Birth Weight ◽  
Fat Free Mass

scholarly journals Energy Expenditure, Protein Oxidation and Body Composition in a Cohort of Very Low Birth Weight Infants

Nutrients ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 3962
Author(s):  
Michela Perrone ◽  
Camilla Menis ◽  
Pasqua Piemontese ◽  
Chiara Tabasso ◽  
Domenica Mallardi ◽  
...  
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Energy Expenditure ◽  
Low Birth Weight ◽  
Human Milk ◽  
Preterm Infants ◽  
Protein Oxidation ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Low Birth Weight Infants

The nutritional management of preterm infants is a critical point of care, especially because of the increased risk of developing extrauterine growth restriction (EUGR), which is associated with worsened health outcomes. Energy requirements in preterm infants are simply estimated, so the measurement of resting energy expenditure (REE) should be a key point in the nutritional evaluation of preterm infants. Although predictive formulae are available, it is well known that they are imprecise. The aim of our study was the evaluation of REE and protein oxidation (Ox) in very low birth weight infants (VLBWI) and the association with the mode of feeding and with body composition at term corrected age. Methods: Indirect calorimetry and body composition were performed at term corrected age in stable very low birth weight infants. Urinary nitrogen was measured in spot urine samples to calculate Ox. Infants were categorized as prevalent human milk (HMF) or prevalent formula diet (PFF). Results: Fifty VLBWI (HMF: 23, PFF: 27) were evaluated at 36.48 ± 0.85 post-conceptional weeks. No significant differences were found in basic characteristics or nutritional intake in the groups at birth and at the assessment. No differences were found in the REE of HMF vs. PFF (59.69 ± 9.8 kcal/kg/day vs. 59.27 ± 13.15 kcal/kg/day, respectively). We found statistical differences in the protein-Ox of HMF vs. PFF (1.7 ± 0.92 g/kg/day vs. 2.8 ± 1.65 g/kg/day, respectively, p < 0.01), and HMF infants had a higher fat-free mass (kg) than PFF infants (2.05 ± 0.26 kg vs. 1.82 ± 0.35 kg, respectively, p < 0.01), measured with air displacement plethysmography. Conclusion: REE is similar in infants with a prevalent human milk diet and in infants fed with formula. The HMF infants showed a lower oxidation rate of proteins for energy purposes and a better quality of growth. A greater amount of protein in HMF is probably used for anabolism and fat-free mass deposition. Further studies are needed to confirm our hypothesis.

scholarly journals Nutrition, Illness and Body Composition in Very Low Birth Weight Preterm Infants: Implications for Nutritional Management and Neurocognitive Outcomes

Nutrients ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 145 ◽  
Author(s):  
Sara E. Ramel ◽  
Jacob Haapala ◽  
Jennifer Super ◽  
Christopher Boys ◽  
Ellen W. Demerath
Keyword(s):  
Body Composition ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Very Low Birth Weight ◽  
Fat Free Mass ◽  
Neurodevelopmental Outcomes ◽  
Prospective Longitudinal Study ◽  
Z Scores ◽  
Prospective Longitudinal

Preterm infants have altered body composition compared to term infants, which impacts both neurodevelopment and metabolic health, but whether increased dietary intake during hospitalization, independent of illness, may improve body composition is unknown. This prospective, longitudinal study (n = 103) measured fat-free mass (FFM) and percent body fat (%BF) at discharge and four months corrected age for prematurity (CA) in very low birth weight (VLBW) preterm infants. Markers of illness and macronutrient intakes (protein and caloric) were recorded. Bayley Scales of Infant Development-III (BSID) were administered at 12 and 24 months of age in a subset of these infants (n = 66 and n = 50 respectively). Body composition z-scores were calculated using recently developed reference curves. Linear regression was used to test the associations between clinical factors and body composition z-scores, as well as z-scores and BSID scores. Increased calories and protein received in the first week after birth and protein intake throughout hospitalization were associated with increased FFM z-scores at discharge, but not with %BF z-scores. After adjustment for both early acute and chronic illness, associations of nutrient intake with FFM z-score remained unchanged. FFM z-scores at discharge were positively associated with scores on the BSID at 12 and 24 months CA. In conclusion, increased energy and protein intakes both early in hospitalization and across its entire duration are associated with higher FFM at discharge, a key marker for organ growth and neurodevelopment in the VLBW neonate. Optimizing caloric intake, irrespective of illness is critical for enhancing body composition, and by extension, neurodevelopmental outcomes for preterm infants.

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