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. 2023 Feb 28;15(5):1224.
doi: 10.3390/nu15051224.

Systematic Review on Individualized Versus Standardized Parenteral Nutrition in Preterm Infants

Walter Mihatsch  1   2 , Miguel Ángel Jiménez Varas  3 , Lucia Lorenzino Diehl  4 , Virgilio Carnielli  5   6 , Rahel Schuler  7 , Corinna Gebauer  8 , Miguel Sáenz de Pipaón Marcos  4
Affiliations

Systematic Review on Individualized Versus Standardized Parenteral Nutrition in Preterm Infants

Walter Mihatsch et al. Nutrients. .

Abstract

The need for high quality evidence is recognized for optimizing practices of parenteral nutrition (PN). The purpose of the present systematic review is to update the available evidence and investigate the effect of standardized PN (SPN) vs. individualized PN (IPN) on protein intake, immediate morbidities, growth, and long-term outcome in preterm infants. A literature search was performed on articles published in the period from 1/2015 to 11/2022 in PubMed and Cochrane database for trials on parenteral nutrition in preterm infants. Three new studies were identified. All new identified trials were nonrandomized observational trials using historical controls. SPN may increase weight and occipital frontal circumference gain and lower the value of maximum weight loss. More recent trials suggest that SPN may easily increase early protein intake. SPN may reduce the sepsis incidence, but overall, no significant effect was found. There was no significant effect of standardization of PN on mortality or stage ≥2 necrotizing enterocolite (NEC) incidence. In conclusion SPN may improve growth through higher nutrient (especially protein) intake and has no effect on sepsis, NEC, mortality, or days of PN.

Keywords: growth; individualized; mortality; necrotizing enterocolitis; nutrition; outcome; parenteral nutrition; preterm infant; protein; safety; sepsis; standardized.

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Conflict of interest statement

The authors declare no conflict of interest with regard to the present systematic review.

Figures

Figure 1
Figure 1
PRISMA flow diagram. (Standardized parenteral nutrition (SPN), individualized parenteral nutrition (IPN)).
Figure 2
Figure 2
Forest plot on the effect of standardized parenteral nutrition (SPN) vs. individualized parenteral nutrition (IPN) on protein intake. Green squares represent individual studies, diamonds represent subgroup analyses.
Figure 3
Figure 3
Forest plot on the effect of standardized parenteral nutrition (SPN) vs. individualized parenteral nutrition (IPN) on mortality, necrotizing enterocolitis (NEC) incidence, and sepsis incidence. Blue squares represent individual studies, diamonds represent subgroup analyses.
Figure 4
Figure 4
Forest plot on the effect of standardized parenteral nutrition (SPN) vs. individualized parenteral nutrition (IPN) on duration of PN (days). Green squares represent individual studies, the diamond represents the subgroup analysis.
Figure 5
Figure 5
Forest plot on the effect of standardized parenteral nutrition (SPN) vs. individualized parenteral nutrition (IPN) on growth. Green squares represent individual studies, diamonds represent subgroup analyses.
See this image and copyright information in PMC

References

    1. Mihatsch W.A., Braegger C., Bronsky J., Cai W., Campoy C., Carnielli V., Darmaun D., Desci T., Domellof M., Embleton N., et al. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition. Clin. Nutr. 2018;37:2303–2305. doi: 10.1016/j.clnu.2018.05.029. - DOI - PubMed
    1. Riskin A., Shiff Y., Shamir R. Parenteral nutrition in neonatology—to standardize or individualize? Isr. Med. Assoc. J. 2006;8:641–645. - PubMed
    1. Riskin A., Picaud J.C., Shamir R. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Standard versus individualized parenteral nutrition. Clin. Nutr. 2018;37:2409–2417. doi: 10.1016/j.clnu.2018.06.955. - DOI - PubMed
    1. National Guideline Alliance (UK) Standardised Neonatal Parenteral Nutrition Formulations. Neonatal Parenteral Nutrition: Evidence Review E. National Institute for Health and Care Excellence (NICE); London, UK: 2020. - PubMed
    1. Rigo J., Senterre T. Intrauterine-like growth rates can be achieved with premixed parenteral nutrition solution in preterm infants. J. Nutr. 2013;143:2066S–2070S. doi: 10.3945/jn.113.177006. - DOI - PubMed

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