The Impact of 2 Weight-Based Standard Parenteral Nutrition Formulations Compared With One Standard Formulation on the Incidence of Hyperglycemia and Hypernatremia in Low Birth-Weight Preterm Infants

Adv Neonatal Care. 2021 Jun 1;21(3):E65-E72. doi: 10.1097/ANC.0000000000000806.

Abstract

Background: Standardized parenteral nutrition (PN) formulations are used in at-risk neonates to provide nutrition immediately following birth. However, evidence for the optimal formulation(s) to maximize growth while reducing the risks of glucose and electrolyte abnormalities is limited.

Purpose: The purpose of this study was to compare the rates of hypernatremia and hyperglycemia with 2 weight-based standardized PN formulations versus one standard PN in low birth-weight preterm neonates.

Methods: This was a single-center observational study of infants less than 1800 g birth weight and less than 37 weeks' gestation who received standardized PN in the first 48 hours of life. Patients in the weight-based PN group were compared with a historical group of patients receiving single standard PN. Rates of hypernatremia and hyperglycemia were compared by χ2 analysis.

Results: There was a nonsignificant (P = .147) reduction in hypernatremia in the weight-based PN group (9 of 87; 10.3%) compared with the single PN group (16 of 89; 18.0%). However, hyperglycemia was significantly more frequent in the weight-based group than in the single PN group (24.1% vs 12.4%, P = .035).

Implications for practice: The 2 weight-based PN standardized formulations studied did not significantly decrease the incidence of hypernatremia or hyperglycemia.

Implications for research: Future studies to determine optimal standardized PN to provide early nutrition in high-risk neonates are warranted.

Publication types

  • Observational Study

MeSH terms

  • Humans
  • Hyperglycemia* / epidemiology
  • Hyperglycemia* / prevention & control
  • Hypernatremia* / epidemiology
  • Hypernatremia* / prevention & control
  • Incidence
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Parenteral Nutrition