Revista de investigacion clinica; organo del Hospital de Enfermedades de la Nutricion · 2013
[Associated factors with complications of the use of parenteral nutrition in premature infants].
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Tapia-Rombo Carlos Antonio, Guerrero-Vara Martha Isabel, Aguilar-Solano Ana Maria Guillermina, Mendoza-Zanella Rosa María, Gómez-de-los-santos Lilia Selenia
Аннотация
INTRODUCTION: Associated factors with complications of the parenteral nutrition (PN) in the preterm infant have not been well studied and there are some controversies in the literature.
OBJECTIVE: To identify associated factors with complications of the use of PN in preterm patients Neonatalogy Service.
MATERIAL AND METHODS: We performed a longitudinal, observational, retrospective, comparative study (case-control) from January 2008 to December 2010, of the infants who received PN support covering the inclusion criteria (newborns 28 to 36 weeks gestational age from 0 to 28 days after birth, who received PN for at least 6 days). We excluded patients with cholestasis by anatomic obstruction hepatobiliary tract, metabolic disease or congenital metabolic syndrome (inborn errors of metabolism). Statistical analysis was done using descriptive statistics and inferential. The associated factors were investigated through the OR (odds ratio) and multivariate analysis. Significance levels were set at p < 0.05.
RESULTS: The total number of patients studied was 67, which is divided into two groups: group A (n = 35) preterm infants with complications secondary to treatment with PN and group B (n = 32), preterm no complications from the procedure. Of all patients in group A, cases, 13 (37%) had mechanical complications; 14 (40%) patients, infectious related with PN or venous catheter (administration via) and 32 (91.4%) patients with metabolic complications as disorders of glucose homeostasis and hyperglycemia predominated (20 patients in group A which corresponds to 57%). In multivariate analysis revealed as protective factors in the use of average protein < 3 g/kg/ day in the first week, osmolarity of the mixture average < 1,200 mOsm/L and relationship non-nitrogenous calories: protein nitrogen > 140:1.
CONCLUSIONS: While there are already installed factors that can not be modified, such as prematurity and low birth weight start nutritional therapy, an adequate proportion of nutrients and osmolality of the mixture can reduce the presence of complications associated with PN.
OBJECTIVE: To identify associated factors with complications of the use of PN in preterm patients Neonatalogy Service.
MATERIAL AND METHODS: We performed a longitudinal, observational, retrospective, comparative study (case-control) from January 2008 to December 2010, of the infants who received PN support covering the inclusion criteria (newborns 28 to 36 weeks gestational age from 0 to 28 days after birth, who received PN for at least 6 days). We excluded patients with cholestasis by anatomic obstruction hepatobiliary tract, metabolic disease or congenital metabolic syndrome (inborn errors of metabolism). Statistical analysis was done using descriptive statistics and inferential. The associated factors were investigated through the OR (odds ratio) and multivariate analysis. Significance levels were set at p < 0.05.
RESULTS: The total number of patients studied was 67, which is divided into two groups: group A (n = 35) preterm infants with complications secondary to treatment with PN and group B (n = 32), preterm no complications from the procedure. Of all patients in group A, cases, 13 (37%) had mechanical complications; 14 (40%) patients, infectious related with PN or venous catheter (administration via) and 32 (91.4%) patients with metabolic complications as disorders of glucose homeostasis and hyperglycemia predominated (20 patients in group A which corresponds to 57%). In multivariate analysis revealed as protective factors in the use of average protein < 3 g/kg/ day in the first week, osmolarity of the mixture average < 1,200 mOsm/L and relationship non-nitrogenous calories: protein nitrogen > 140:1.
CONCLUSIONS: While there are already installed factors that can not be modified, such as prematurity and low birth weight start nutritional therapy, an adequate proportion of nutrients and osmolality of the mixture can reduce the presence of complications associated with PN.