Nutrición parenteral agresiva y velocidad media de crecimiento en recién nacidos <1,500 g en un hospital de 3.er nivel de la Ciudad de México

Abstract

Introduction

«Aggressive» parenteral nutrition (PN) may improve birth-weight recovery (BWR) and early weight gain.

Objective

To compare BWR and mean growth rate (MGR) with 2 nutrition strategies.

Material and methods

A comparative descriptive analysis was performed on 64 newborns with birth-weight < 1500 g admitted to the Neonatal Intensive Care Unit of the National Institute of Perinatology (México City) in 2013 (A) vs. 34 neonates of 2001 with same birth-weight (B). The variables recorded were, weight loss during first week, recovery birth-weight, MGR for weight, length, and head circumference in the 1st, 2nd, and 3rd week, intake of proteins, lipids and glucose in PN within first 24 h of life, and days using PN. Statistical analysis included the mean, SD, and Student t test, was performed using with SPSS v. 20.

Results

MGR in 1st week, A = 2.5 vs. B = −20 (P = 0.004), in the 2nd, 11.7 vs. −6.4 (P = 0.000), and in the 3rd 12.2 vs. −5.6 g/kg/d (P = 0.000); length 0.076 vs. 0.039 (P = 0.010), and head circumference 0.075 vs. 0.035 cm/day (P = .018). Weight loss 16.6 vs. 24.41 g/day (P = 0.000). Mean birth-weight recovery 11.5 vs. 41.4 days (P = 0.000). PN initiated: glucose of 6.1 mg/kg per min vs. 6 (P = 0.000), protein 3.05 vs. 1.46 (P = 0.000), and lipids 1.77 vs. 1.01 g/kg per day (P = 0.001). Calorie intake by the first PN was 48.8 vs. 35.4 kcal (P = 0.000). In group A, the mean duration of PN was 21.2 d and initiation of enteral feeding at 5 day.

Conclusion

Aggressive PN from first day of life showed reduced nutritional deficiency and posnatal growth restriction.