Nutrición parenteral en pediatría: ¿soluciones normalizadas mejor que individualizadas?

[Is it worth knowing the characteristics of inpatient paediatric parenteral nutrition?]

OBJECTIVE

To describe the characteristics of inpatient parenteral nutrition during 2008 in a tertiary level paediatric hospital. To compare this practice with recent standards.

MATERIAL AND METHODS

Longitudinal, descriptive, and retrospective study of patients under 16 years receiving parenteral nutrition in 2008. Demographic data as well as data of the nutritional support were recorded.

RESULTS

A total of 120 children received parenteral nutrition, of whom 63 were under 2 years, 30 between 3 and 7 years, and 27 older than 7 years. They accounted for 1.6% of all the inpatients during that period. Most frequent indication was gastrointestinal surgery (35.5%), followed by non-surgical gastrointestinal diseases (19.8%). The average composition in the first day of parenteral nutrition was: 63.1kcal/kg (SD: 21.3); volume, 76.6ml/kg (SD: 28.4); carbohydrates 9.6g/kg/d (SD: 3.2); amino acids 2.1g/kg/d (SD: 0.6), and lipids 1.9g/kg/d (SD: 1). The mean duration of parenteral support was 10.5 days (SD: 9.8). Internal jugular vein (34.7%) and femoral vein were the most common intravenous access. The main reason to discontinue parenteral nutrition was transition to oral/enteral feedings. The complication rate was 27.3%.

CONCLUSIONS

There is an interest in evaluating standard practice in parenteral nutrition in order to develop improvement strategies. Infants and toddlers are the principal candidates for parenteral nutrition. Standardisation is one way to decrease errors in its preparation and prescription.