Abstract
Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 38-43.e1 |
| Journal | Journal of Pediatrics |
| Volume | 202 |
| DOIs | |
| State | Published - Nov 1 2018 |
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Keywords
- energy
- factors
- neonatal
- NICU
- phase
- protein
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
Cite this
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Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight. / Falciglia, Gustave H.; Murthy, Karna; Holl, Jane L.; Palac, Hannah L.; Oumarbaeva, Yuliya; Woods, Donna M.; Robinson, Daniel T.
In: Journal of Pediatrics, Vol. 202, 01.11.2018, p. 38-43.e1.Research output: Contribution to journal › Article
TY - JOUR
T1 - Energy and Protein Intake During the Transition from Parenteral to Enteral Nutrition in Infants of Very Low Birth Weight
AU - Falciglia, Gustave H.
AU - Murthy, Karna
AU - Holl, Jane L.
AU - Palac, Hannah L.
AU - Oumarbaeva, Yuliya
AU - Woods, Donna M.
AU - Robinson, Daniel T.
PY - 2018/11/1
Y1 - 2018/11/1
N2 - Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.
AB - Objective: To evaluate the association between nutrition delivery practices and energy and protein intake during the transition from parenteral to enteral nutrition in infants of very low birth weight (VLBW). Study design: This was a retrospective analysis of 115 infants who were VLBW from a regional neonatal intensive care unit. Changes in energy and protein intake were estimated during transition phase 1 (0% enteral); phase 2 (>0, ≤33.3% enteral); phase 3 (>33.3, ≤66.7% enteral); phase 4 (>66.7, <100% enteral); and phase 5 (100% enteral). Associations between energy and protein intake were determined for each phase for parenteral nutrition, intravenous lipids, central line, feeding fortification, fluid restriction, and excess non-nutritive fluid intake. Results: In phases 2 and 3, infants receiving feeding fortification received less protein than infants who were unfortified (−1.1 and −0.3 g/kg/d, respectively; P <.001). However, this negative association was not observed after adjusting for relevant nutrition delivery practices. Despite greater enteral protein intake during phases 2 and 3 (0.3 and 0.8 g/kg/d, respectively; P <.001), infants with early fortification received less parenteral protein than infants who were unfortified (−1.4 and −1.1 g/kg/d, respectively; P <.001). Similar patterns were observed for energy intake. Protein intake declined during phases 3 and 4. Conclusions: Infants paradoxically received less protein and energy on days with early fortification, suggesting that clinicians may lack easily accessible data to detect the association between nutrition delivery practices and overall nutrition in infants who are VLBW.
KW - energy
KW - factors
KW - neonatal
KW - NICU
KW - phase
KW - protein
UR - http://www.scopus.com/inward/record.url?scp=85055180417&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85055180417&partnerID=8YFLogxK
U2 - 10.1016/j.jpeds.2018.07.010
DO - 10.1016/j.jpeds.2018.07.010
M3 - Article
C2 - 30195557
AN - SCOPUS:85055180417
VL - 202
SP - 38-43.e1
JO - Journal of Pediatrics
JF - Journal of Pediatrics
SN - 0022-3476
ER -