The Experts below are selected from a list of 1734 Experts worldwide ranked by ideXlab platform
Satyan Lakshminrusimha - One of the best experts on this subject based on the ideXlab platform.
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pleural effusion with Parenteral Nutrition Solution an unusual complication of an appropriately placed umbilical venous catheter
American Journal of Perinatology, 2007Co-Authors: Maria Janina U Pabalan, Ralph J Wynn, Anne Marie Reynolds, Rita M Ryan, Mostafa Youssfi, Veena Manja, Satyan LakshminrusimhaAbstract:: Pleural effusion is not an uncommon complication of percutaneous intravenous catheters in neonates. Umbilical venous catheters (UVCs) are associated with pleural effusion following abnormal placement in the left atrium or pulmonary veins due to venous obstruction. We report for the first time a case of right-sided pleural effusion with Parenteral Nutrition Solution following a UVC that appeared to be positioned appropriately in the inferior vena cava.
Thibault Senterre - One of the best experts on this subject based on the ideXlab platform.
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intrauterine like growth rates can be achieved with premixed Parenteral Nutrition Solution in preterm infants
Journal of Nutrition, 2013Co-Authors: Jacques Rigo, Thibault SenterreAbstract:Growth failure in neonatal intensive care units is a major challenge for pediatricians and neonatologists. The use of early "aggressive" Parenteral Nutrition (PN), with >2.5 g/(kg ·d) of amino acids and at least 40 kcal/(kg ·d) of energy from the first day of life, has been shown to provide Nutritional intakes in the range recommended by international guidelines, reducing Nutritional deficit and the incidence of postnatal growth restriction in preterm infants. However, Nutritional practices and adherence to recommendations may vary in different hospitals. Two ready-to-use (RTU), premixed Parenteral Solutions (PSs) designed for preterm infants have been prospectively evaluated: a binary RTU premixed PS from our hospital pharmacy and a commercially premixed 3-chamber bag (Baxter Healthcare). These premixed PSs provide nitrogen and energy intakes in the range of the most recent recommendations, reducing or eliminating the early cumulative Nutritional deficit in very-low-birth-weight infants, and avoiding the development of postnatal growth restriction. A further rationale for RTU premixed PSs is that preterm infants require balanced PN that contains not only amino acids and energy but also minerals and electrolytes from the first day of life in order to reduce the incidence of metabolic disorders frequently reported in extremely-low-birth-weight infants during the early weeks of life.
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1385 optimizing Nutrition after birth with a unique standardized Parenteral Solution may reduce electrolytes anomalies in 1250g infants
Archives of Disease in Childhood, 2012Co-Authors: Thibault Senterre, Jacques RigoAbstract:Nutritional recommendations in VLBW infants advised to increase protein and energy intakes but also advised to avoid Parenteral Nutrition electrolytes intakes during the first 2–3 days of life to reduce electrolytes anomalies that are frequently observed. The Aim of this study is to evaluate the electrolytes tolerance of an optimized Nutritional program using a unique standardized Parenteral Nutrition Solution (StPNsol) containing electrolytes from the first day of life in On the first day of life, PN intakes from the StPNsol included 38±6 kcal/kg*d, 2.4±0.3 g/kg*d of protein, 0.8±0.4 mmol/kg*d of sodium and 0.8±0.4 mmol/kg*d potassium. Afterwards, Nutritional intakes rapidly increased. Hypernatremia >150 mmol/L occurs in 16 infants (15.6%), on 27 days (1.8%), essentially between 1 and 3 days of life (19 days). Hyponatremia No infant develops a hyperkaliemia >7 mmol/L. Hypokaliemia This study demonstrates that increasing protein and energy intakes with a StPNsol containing electrolytes from the first day of life is not associated with an increased incidence of hypernatremia or non-oliguric hyperkaliemia. Furthermore, this study seem to suggest that optimizing Nutritional intakes and increasing anabolism may require higher electrolytes intakes than usually recommended during the first days of life in VLBW infants.
Alexandra Scrivens - One of the best experts on this subject based on the ideXlab platform.
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p36 numeta g13 preterm neonatal Parenteral Nutrition Solution a licensed all in one triple chamber ready to use and terminally sterilised Parenteral Nutrition for preterm newborn infants
Archives of Disease in Childhood, 2020Co-Authors: Mar Moreno, Kenny Mccormick, Lindsey Macfarlane, Alexandra ScrivensAbstract:Aims We aim to evaluate the efficacy and safety of Numeta G13%E preterm neonatal Parenteral Nutrition (PN) in our neonatal population. In September 2017 a National Patient Safety Alert (NPSA) highlighted the risk of harm to babies when lipid was mistakenly run at the rate intended for the aqueous component resulting in significant lipid overdose. Although we have worked to implement many of the alert’s recommendations, we feel we can avoid this risk further by using an all-in-one PN Solution.1 Numeta meets current Nutritional guidelines as per British Association of Perinatal Medicine (BAPM) but this project allows comparison of outcomes important to both patient and service between those achieved with our current regimen and those with the all-in-one regimen.2 Methods We carried out a quality improvement project from April 2018 to April 2019. We collected data from 330 babies in our neonatal unit during six months before (154 babies) and after (176 babies) the adoption of the all-in-one Solution. Our previous PN regimen consisted of a ‘menu’ of aqueous bags (starter, maintenance, ‘light’ and bespoke) and a separate lipid Solution. All of them were suitable for peripheral or central administration. Numeta came with similar choices: starter, maintenance -for central administration only- and ‘lite’ and Numeta peripheral, suitable for peripheral administration. Bespoke bags were also available if clinically indicated. We set out our desired outcomes and measured parameters accordingly: Patient outcomes Metabolic stability: electrolyte, glucose, bilirubin and lipid measurements summarised by the need to change from standard PN regimen and/or requirement for insulin. Fluid balance summarised by the lowest weight during the first two weeks of life and time taken to regain birth weight. Growth summarised by change of standard deviation score of weight and head circumference between birth and discharge or transfer back to local hospital. Liver tolerance of lipid Solutions summarised by incidence of cholestasis (>25 μmol/l conjugated fraction of serum bilirubin) Days and type of PN Sepsis Service outcomes Nursing time taken to prepare PN Cost Wastage Access to product Results Although we finished collecting the data in April 2019, we are still in the process of analysing it and evaluating the final results. There have been no cases of lipid overdose and our neonates (including the preterm ones) have so far tolerated well the new Parenteral Nutrition Solution. Average nursing time preparing Numeta went down from 18.5 minutes to 8 minutes and comparison of cost came in favour of Numeta. PN wastage was higher with Numeta (4.7% Maintenance, 10% ‘light’, peripheral 50%) especially in the first month during the transition phase. There was no significant increase of bespoke bags when Numeta was introduced. Conclusions In summary, so far we have not identified significant clinical differences between the first six months of the project -using our old standardised Nutrition regimen- and the last months -on the new all-in-one Solution. We have continued with Numeta preterm Solution on the basis of assumed safety. References Risk of severe harm and death from infusing total Parenteral Nutrition too rapidly in babies. NHS improvement patient safety alert September 2017. The Provision of Parenteral Nutrition within Neonatal Services – A Framework for Practice. British Association of Perinatal Medicine (BAPM) April 2016 www.bapm.org
Jacques Rigo - One of the best experts on this subject based on the ideXlab platform.
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intrauterine like growth rates can be achieved with premixed Parenteral Nutrition Solution in preterm infants
Journal of Nutrition, 2013Co-Authors: Jacques Rigo, Thibault SenterreAbstract:Growth failure in neonatal intensive care units is a major challenge for pediatricians and neonatologists. The use of early "aggressive" Parenteral Nutrition (PN), with >2.5 g/(kg ·d) of amino acids and at least 40 kcal/(kg ·d) of energy from the first day of life, has been shown to provide Nutritional intakes in the range recommended by international guidelines, reducing Nutritional deficit and the incidence of postnatal growth restriction in preterm infants. However, Nutritional practices and adherence to recommendations may vary in different hospitals. Two ready-to-use (RTU), premixed Parenteral Solutions (PSs) designed for preterm infants have been prospectively evaluated: a binary RTU premixed PS from our hospital pharmacy and a commercially premixed 3-chamber bag (Baxter Healthcare). These premixed PSs provide nitrogen and energy intakes in the range of the most recent recommendations, reducing or eliminating the early cumulative Nutritional deficit in very-low-birth-weight infants, and avoiding the development of postnatal growth restriction. A further rationale for RTU premixed PSs is that preterm infants require balanced PN that contains not only amino acids and energy but also minerals and electrolytes from the first day of life in order to reduce the incidence of metabolic disorders frequently reported in extremely-low-birth-weight infants during the early weeks of life.
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1385 optimizing Nutrition after birth with a unique standardized Parenteral Solution may reduce electrolytes anomalies in 1250g infants
Archives of Disease in Childhood, 2012Co-Authors: Thibault Senterre, Jacques RigoAbstract:Nutritional recommendations in VLBW infants advised to increase protein and energy intakes but also advised to avoid Parenteral Nutrition electrolytes intakes during the first 2–3 days of life to reduce electrolytes anomalies that are frequently observed. The Aim of this study is to evaluate the electrolytes tolerance of an optimized Nutritional program using a unique standardized Parenteral Nutrition Solution (StPNsol) containing electrolytes from the first day of life in On the first day of life, PN intakes from the StPNsol included 38±6 kcal/kg*d, 2.4±0.3 g/kg*d of protein, 0.8±0.4 mmol/kg*d of sodium and 0.8±0.4 mmol/kg*d potassium. Afterwards, Nutritional intakes rapidly increased. Hypernatremia >150 mmol/L occurs in 16 infants (15.6%), on 27 days (1.8%), essentially between 1 and 3 days of life (19 days). Hyponatremia No infant develops a hyperkaliemia >7 mmol/L. Hypokaliemia This study demonstrates that increasing protein and energy intakes with a StPNsol containing electrolytes from the first day of life is not associated with an increased incidence of hypernatremia or non-oliguric hyperkaliemia. Furthermore, this study seem to suggest that optimizing Nutritional intakes and increasing anabolism may require higher electrolytes intakes than usually recommended during the first days of life in VLBW infants.
Thomas M. Rossi - One of the best experts on this subject based on the ideXlab platform.
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Total Parenteral Nutrition-Induced Steatosis: Reversal by Parenteral Lipid Infusion
JPEN. Journal of parenteral and enteral nutrition, 1991Co-Authors: S. Reif, M. Tano, R. Oliverio, C. Young, Thomas M. RossiAbstract:Prolonged use of total Parenteral Nutrition (TPN) may be associated with hepatic complications, primarily steatosis and cholestasis. A case is reported of an 18-year-old woman with chronic idiopathic intestinal pseudo-obstruction syndrome who was on prolonged home Parenteral Nutrition without lipid supplementation and developed steatosis. This finding was reversed by addition of lipid emulsion, at a dose of 0.5 g/kg/day, to the Parenteral Nutrition Solution. The lack of lipid supplementation as a possible cause of steatosis, as well as other mechanisms of liver steatosis associated with TPN, are discussed.
