Neonates parenteral nutrition

Laborie, S., Lavoie, J- ., Pineaut, M., and Chessex, P. (2000), Contribution of multivitamins, air and light in the generation of peroxides in adult and neonatal parenteral nutrition solutions, Ann. Pharmacother., 34, 440M45. 

Peverini RL, Beach DS, Wan KW, Vyhmeister NR. Graphical user interface for a neonatal parenteral nutrition decision support system. Proc AMIA Symp 2000 650-654. 

The actual aluminium contents in 40 neonatal parenteral nutrition solutions and 16 component products used in parenteral nutrition formulations have been determined and compared with the calculated amounts from manufacturers product labels, and ascertain whether the actual aluminium exposure exceeds the FDA recommended maximum [14 ]. The measured and calculated aluminium concentrations exceeded the FDA recommended safe... 

Huston RK, Baxter LM, Larrabee PB. Neonatal parenteral nutrition hypersensitivity a case report implicating bisulfite sensitivity in a newborn infant. JPEN J Parenter Enteral Nutr 2009 33(6) 691-3. 

Peroxide formation has also been observed in multivitamin solutions for parenteral nutrition. Lavoie and co-workers [30] have studied the action of light, air, and composition on the stability of multivitamin formulations, and also total parenteral nutrition (TPN) admixtures containing and not containing vitamins and fatty acids. They analyzed the generation of peroxide in multivitamin solutions and in TPN for adults and neonates. The analysis of multivitamin solutions for enteral use revealed the presence of peroxides at the initial opening of the bottle. The levels were higher in Poly-Vi-Sol (vitamin A, Vitamin D, and vitamin C, vitamin Bb riboflavin, and... 

Exposures of neonatal children to DEHP can be especially high as a result of some medical procedures. For example, upper-bound doses of DEHP have been estimated to be as high as 2.5 mg/kg/day during total parenteral nutrition (TPN) administration and 14 mg/kg/day during extracorporeal membrane oxygenation (ECMO) procedures. 

Umbilical venous catheters are commonly used in neonatal care for drug administration and parenteral nutrition. However, many risks are associated with their use. Ascites associated with parenteral nutrition have been reported (19). 

Cheah FC, Boo NY, Latif JY. An unusual case of refractory hypoglycaemia in a neonate receiving total parenteral nutrition. Acta Paediatr 2000 89(4) 497-8. 

In a series of neonates on total long-term parenteral nutrition, cholestatic disorders were associated with high manganese concentrations (over 360 nmol/1) (21). 

Calcium is normally considered to be safe in parenteral nutrition, and relatively high quantities are often included in neonatal and pediatric formulations. However, there is a risk of hjrpercalciuria. The pathogenesis of hjrpercal-ciuria is not readily explicable on the basis of endocrine or metabolic effects, but it has been postulated to be due to excessive calcium or vitamin D intake or aluminium overload. 

In a retrospective study of the incidence of cholestasis and liver failure in 42 patients with intestinal resection in the neonatal period who subsequently became dependent on parenteral nutrition support, the effect of various associated clinical factors on the incidence and severity of cholestasis was determined (103). Cholestasis developed in 28 while they were receiving parenteral nutrition. In 21 patients, the raised direct bilirubin concentration returned to normal while they continued to receive parenteral nutrition. Seven patients progressed to liver failure. Patients without cholestasis had been dependent on parenteral nutrition for longer than patients with cholestasis. It was clear from this study that cholestasis in neonates with intestinal resection is not simply a function of the duration of exposure to intravenous nutrition. 

Tibboel D, Delemarre FM, Przyrembel H, Bos AP, Affourtit MJ, Molenaar JC. Carnitine deficiency in surgical neonates receiving total parenteral nutrition. J Pediatr Surg 1990 25(4) 418-21. 

Morgan W 3rd, Yardley J, Luk G, Niemiec P, Dudgeon D. Total parenteral nutrition and intestinal development a neonatal model. J Pediatr Surg 1987 22(6) 541-5. 

Sondheimer JM, Asturias E, Cadnapaphornchai M. Infection and cholestasis in neonates with intestinal resection and long-term parenteral nutrition. J Pediatr Gastroenterol Nutr 1998 27(2) 131-7. 

Fok TF, Chui KK, Cheung R, Ng PC, Cheung KL, Hjelm M. Manganese intake and cholestatic jaundice in neonates receiving parenteral nutrition a randomized controlled study. Acta Paediatr 2001 90(9) 1009-15. 

Levine A, Maayan A, Shamir R, Dinari G, Sulkes J, Sirotta L. Parenteral nutrition-associated cholestasis in preterm neonates evaluation of ursodeoxycholic acid treatment. J Pediatr Endocrinol Metab 1999 12(4) 549-53. 

Coley BD, Seguin J, Cordero L, Hogan MJ, Rosenberg E, Reber K. Neonatal total parenteral nutrition ascites from hver erosion by umbilical vein catheters. Pediatr Radiol 1998 28(12) 923-7. 

Eggert LD, Rusho WJ, Mackay MW, Chan GM. Calcium and phosphorus compatibility in parenteral nutrition solutions for neonates. Am J Hasp Pharm 1982 39 49-53. 

Pereira-da-Silva L, Nurmamodo A, Amaral JM, et al. Compatibility of calcium and phosphate in four parenteral nutrition solutions for preterm neonates. Am J Health Syst Pharm 2003 60 1041-1044. 

Koo WWK, Cepeda EE. Parenteral nutrihon in neonates. In Rombeau JL, Rolandelli RH, eds. Clinical Nutrihon Parenteral Nutrition, 3rd ed. Philadelphia, Saunders, 2001 463-475. 

All infants, on admission to the neonatal intensive care unit, were established on parenteral fluids within the first hour of day 1 at 80 ml/kg/day with a solution of electrolytes, dextrose 10%, amino acids (Vaminolact, Fresenius Kabi, Cheshire, UK) and a phosphate supplement (Addiphos, Fresenius Kabi, Cheshire, UK). Fluid intakes were thereafter managed on the basis of clinical requirements. On day 2 of life, and thereafter, the solution was further supplemented with water-soluble vitamins (Solvito N, Fresenius Kabi, Cheshire, UK) and trace elements (Peditrace, Fresenius Kabi, Cheshire, UK), to the levels recommended by the manufacmrer. In tandem, a fat emulsion solution (Intralipid 20%, Fresenius Kabi, Cheshire, UK) with added fat-soluble vitamins (Vitfipid, Fresenius Kabi, Cheshire, UK) was infused, initially at 8ml/kg/ day, increasing maximally to 18 ml/kg/day by posma-tal day 5. Enteral feeds were started, when the condition of the infant was stable, as hourly boluses of 0.5—1 ml/h. Thereafter enteral feed volumes were gradually increased as determined by the infants clinical condition, with reciprocal reductions in the volume of parenteral nutrition infused. No infant progressed beyond hourly bolus feeds for the duration of the study. 

If trials of iodide supplementation of parenteral nutrition show that supplementation improves neurodeveiop-mental outcome, there will be immediate implications for clinical management for neonates and children up to 15 kg (3—4 years of age). 

Poole RL, Schiff L, Hintz SR, Wong A, Mackenzie N, Kemer JA Jr. Aluminum content of parenteral nutrition in neonates measured versus calculated levels. J Pediatr Gastroenterol Nutr 2010 50(2) 201-11. 

A full-term neonate weight, 3.45 kg, was referred at 60 days of age for surgery for short bowel secondary to a mid-gut volvulus. He was given parenteral nutrition and after 4 months developed conjugated hyperbilirubinemia. He... 

In contrast, in a retrospective analysis of 292 neonates who received parenteral nutrition with lipid emulsions containing omega-3 fatty acids for more than 1 day, 104 (36%) developed cholestasis after a mean of 22 days, with a conjugated bilirubin concentration over 34 pmol/l 31 had a serum conjugated bilirubin concentration over 100 pmoUl and 13 developed liver failure 4 underwent transplantation and 5 died of hepatic disease [385]. The authors suggested that in the absence of definitive evidence of efficacy, as well as increased costs, it is difficult to justify the routine use of lipid... 

Birch P, Ogden S, Hewson M. A randomised, controlled trial of heparin in total parenteral nutrition to prevent sepsis associated with neonatal long lines the Heparin in Long Line Total Parenteral Nutrition (HILLTOP) trial. Arch Dis Child Fetal Neonatal Ed 2010 95(4) F252-7. 

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