Parenteral Nutrition Prescribing Pattern: A Medical Chart Review of 191 Preterm Infants

Background: In 2005, the European Society for Clinical Nutrition and Metabolism released guidelines for the use of pediatric parenteral nutrition (PN). The purpose of this study was to compare PN prescribing patterns in preterm infants with current guideline recommendations. Materials and Methods: Six neonatologists in Germany conducted observational, retrospective medical chart reviews on preterm infants < 28 days postnatal, hospitalized from October 2009 to April 2011. Infants with a complete medical record who received PN for a minimum of 4 days were enrolled. Patient weight and the change in daily amino acids and intravenous fat emulsion (IVFE) doses administered for the first 7 days of life were abstracted. Median data were used to determine quartiles to compare study results with the current guidelines. Results: Only 30% of patients met current guidelines that recommend all preterm infants receive amino acids on the first day of life. When amino acids were given, the dose was lower than recommended in the current guidelines. The start of IVFE by day 3 of life was given only to 34% of patients despite the guideline recommendation of 100%. Conclusion: This study identified several gaps between the current guidelines and patient care that should be explored further. (Nutr Clin Pract. 2013; 28: 242-246)