Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes

Nutrients

Silvia Guiducci¹  Laura Moschino¹  Maria Elena Cavicchiolo¹  Giovanna Verlato¹  Marta Meneghelli¹  Luca Bonadies¹  Miriam Duci²  Francesco Fascetti Leon² 

[1] Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy;Pediatric Surgery Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy;

关键词: necrotizing enterocolitis;    surgery;    parenteral nutrition;    macronutrients;    micronutrients;    parenteral nutrition associated liver disease;   

DOI  :  10.3390/nu14050919

来源: DOAJ

【 摘 要 】

Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies.

【 授权许可】

Unknown