Standardised neonatal parenteral nutrition formulations - Australasian neonatal parenteral nutrition consensus update 2017

Srinivas Bolisetty^{1

2}, David Osborn^{3

4}, Tim Schindler⁵, John Sinn^{4

6}, Girish Deshpande⁷, Chee Sing Wong⁸, Susan E Jacobs⁹, Nilkant Phad¹⁰, Pramod Pharande¹¹, Rodney Tobiansky¹², Melissa Luig¹³, Amit Trivedi¹⁴, Joanne Mcintosh¹⁰, Eszter Josza¹⁵, Gillian Opie¹⁶, Lyn Downe⁷, Chad Andersen¹⁷, Vineesh Bhatia¹⁷, Prasanna Kumar¹⁸, Katri Malinen¹⁹, Pita Birch²⁰, Karen Simmer²¹, Gemma McLeod²², Suzanne Quader²³, Victor Samuel Rajadurai²⁴, Michael Patrick Hewson²⁵, Arun Nair²⁶, Megan Williams¹¹, Jing Xiao²⁷, Hari Ravindranathan²⁸, Roland Broadbent²⁹, Kei Lui³⁰

Affiliations

¹ Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia. Srinivas.bolisetty@health.nsw.gov.au.
² Conjoint Lecturer, University of New South Wales, Sydney, Australia. Srinivas.bolisetty@health.nsw.gov.au.
³ Royal Prince Alfred Hospital, Sydney, Australia.
⁴ University of Sydney, Sydney, Australia.
⁵ Royal Hospital for Women, University of New South Wales, Sydney, Australia.
⁶ Royal North Shore Hospital, Sydney, Australia.
⁷ Nepean Hospital, Sydney, Australia.
⁸ Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁹ Deputy Clinical Director and Neonatal Paediatrician, The Royal Women's Hospital, Parkville, Victoria, Australia.
¹⁰ John Hunter Children's Hospital, Newcastle, Australia.
¹¹ Monash Children's Hospital, Clayton, Victoria, Australia.
¹² Liverpool Hospital, Sydney, Australia.
¹³ Westmead Hospital, Sydney, Australia.
¹⁴ The Children's Hospital at Westmead, Sydney, Australia.
¹⁵ Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia.
¹⁶ Head and Neonatal Paediatrician, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
¹⁷ Head of Neonatology, Women's and Children's Hospital, North Adelaide, Australia.
¹⁸ Townsville Hospital, Townsville, Australia.
¹⁹ PGCert Clinical Education, PGDip Child Health (associate), Advanced Pharmacist, Townsville Hospital, Townsville, Australia.
²⁰ Gold Coast University Hospital, Southport, Australia.
²¹ King Edward Memorial Hospital for Women, Subiaco, Australia.
²² King Edward Memorial and Princess Margaret Hospitals, Subiaco, Australia.
²³ The Sydney Children's Hospital Network, Sydney, Australia.
²⁴ Department of Neonatology, KK Women's and Children's Hospital, Kampong Java, Singapore.
²⁵ Wellington Hospital, Wellington South, New Zealand.
²⁶ Waikato Hospital, Hamilton, New Zealand.
²⁷ Nepean Hospital, Penrith, Australia.
²⁸ Paediatric Intensivist, Sydney Children's Hospital, Sydney, Australia.
²⁹ Dunedin School of Medicine, Dunedin, New Zealand.
³⁰ University of New South Wales, Sydney, Australia.

PMID: 32035481
PMCID: PMC7007668
DOI: 10.1186/s12887-020-1958-9

Standardised neonatal parenteral nutrition formulations - Australasian neonatal parenteral nutrition consensus update 2017

Srinivas Bolisetty et al. BMC Pediatr. 2020.

. 2020 Feb 8;20(1):59.

doi: 10.1186/s12887-020-1958-9.

Authors

Affiliations

¹ Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia. Srinivas.bolisetty@health.nsw.gov.au.
² Conjoint Lecturer, University of New South Wales, Sydney, Australia. Srinivas.bolisetty@health.nsw.gov.au.
³ Royal Prince Alfred Hospital, Sydney, Australia.
⁴ University of Sydney, Sydney, Australia.
⁵ Royal Hospital for Women, University of New South Wales, Sydney, Australia.
⁶ Royal North Shore Hospital, Sydney, Australia.
⁷ Nepean Hospital, Sydney, Australia.
⁸ Hospital Kuala Lumpur, Kuala Lumpur, Malaysia.
⁹ Deputy Clinical Director and Neonatal Paediatrician, The Royal Women's Hospital, Parkville, Victoria, Australia.
¹⁰ John Hunter Children's Hospital, Newcastle, Australia.
¹¹ Monash Children's Hospital, Clayton, Victoria, Australia.
¹² Liverpool Hospital, Sydney, Australia.
¹³ Westmead Hospital, Sydney, Australia.
¹⁴ The Children's Hospital at Westmead, Sydney, Australia.
¹⁵ Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia.
¹⁶ Head and Neonatal Paediatrician, Mercy Hospital for Women, Heidelberg, Victoria, Australia.
¹⁷ Head of Neonatology, Women's and Children's Hospital, North Adelaide, Australia.
¹⁸ Townsville Hospital, Townsville, Australia.
¹⁹ PGCert Clinical Education, PGDip Child Health (associate), Advanced Pharmacist, Townsville Hospital, Townsville, Australia.
²⁰ Gold Coast University Hospital, Southport, Australia.
²¹ King Edward Memorial Hospital for Women, Subiaco, Australia.
²² King Edward Memorial and Princess Margaret Hospitals, Subiaco, Australia.
²³ The Sydney Children's Hospital Network, Sydney, Australia.
²⁴ Department of Neonatology, KK Women's and Children's Hospital, Kampong Java, Singapore.
²⁵ Wellington Hospital, Wellington South, New Zealand.
²⁶ Waikato Hospital, Hamilton, New Zealand.
²⁷ Nepean Hospital, Penrith, Australia.
²⁸ Paediatric Intensivist, Sydney Children's Hospital, Sydney, Australia.
²⁹ Dunedin School of Medicine, Dunedin, New Zealand.
³⁰ University of New South Wales, Sydney, Australia.

PMID: 32035481
PMCID: PMC7007668
DOI: 10.1186/s12887-020-1958-9

Abstract

Background: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines.

Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed.

Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed.

Conclusions: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.

Keywords: Consensus; Neonate; Parenteral nutrition; Preterm; Standardisation.

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Conflict of interest statement

Authors have no competing (financial or non-financial) interests to declare.

References

1. Bolisetty S, Osborn D, Sinn J, Lui K. Australasian Neonatal Parenteral Nutrition Consensus Group. Standardised neonatal parenteral nutrition formulations-an Australasian group consensus 2012. BMC Pediatr. 2014;14:48. doi: 10.1186/1471-2431-14-48. - DOI - PMC - PubMed
1. Bolisetty S, Pharande P, Nirthanakumaran L, Do TQ, Osborn D, Smyth J, et al. Improved nutrient intake following implementation of the consensus standardised parenteral nutrition formulations in preterm neonates – a before-after intervention study. BMC Pediatr. 2014;14:309. doi: 10.1186/s12887-014-0309-0. - DOI - PMC - PubMed
1. Tan A, Osborn D, Sinn J, Schindler T, Lui K, Bolisetty S. Neonatal Parenteral Nutrition Consensus Group Survey: Proceedings of the Neonatal Parenteral Nutrition Consensus Group 2015 Meeting. Sydney; 2015.
1. NHMRC . Levels of evidence and grades for recommendations for developers of guidelines. 2009.
1. American Academy of the Pediatric (AAP) Committee on Nutrition: Nutritional needs of the preterm infant. In: Kleinman RE, editor. Pediatric Nutrition. 7. IL, USA: AAP; 2014. pp. 83–121.

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Standardised neonatal parenteral nutrition formulations - Australasian neonatal parenteral nutrition consensus update 2017

Affiliations

Standardised neonatal parenteral nutrition formulations - Australasian neonatal parenteral nutrition consensus update 2017

Authors

Affiliations

Abstract

Conflict of interest statement

References

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