Early versus late parenteral nutrition in term and late preterm infants: a randomised controlled trial.
Neonatology
Journal
BMJ paediatrics open
ISSN: 2399-9772
Titre abrégé: BMJ Paediatr Open
Pays: England
ID NLM: 101715309
Informations de publication
Date de publication:
12 May 2024
12 May 2024
Historique:
received:
15
02
2024
accepted:
09
04
2024
medline:
13
5
2024
pubmed:
13
5
2024
entrez:
12
5
2024
Statut:
epublish
Résumé
There is limited evidence regarding the optimal time to commence parenteral nutrition (PN) in term and late preterm infants. Single-centre, non-blinded, exploratory randomised controlled trial. A level-3 neonatal unit in a stand-alone paediatric hospital. Infants born ≥34 weeks of gestation and ≤28 days, who needed PN. Eligible infants were randomised on day 1 or day 2 of admission. Early (day 1 or day 2 of admission, N=30) or late (day 6 of admission, N=30) PN. Plasma phenylalanine and F The postnatal age at randomisation was similar between the groups (2.3 (SD 0.8) vs 2.3 (0.7) days, p=0.90). On day 4, phenylalanine levels in early-PN infants were higher than in late-PN (mean (SD) 62.9 (26.7) vs 45.5 (15.3) µmol/L; baseline-adjusted percentage difference 25.8% (95% CI 11.6% to 39.9%), p<0.001). There was no significant difference in phenylalanine levels between the two groups on day 8. There was no significant difference between the groups for F The timing of the commencement of PN did not seem to affect the degree of oxidative stress in critically ill term and late preterm infants. The effect of transiently high plasma phenylalanine with early PN on clinical outcomes requires further investigation. ACTRN12620000324910.
Sections du résumé
BACKGROUND
BACKGROUND
There is limited evidence regarding the optimal time to commence parenteral nutrition (PN) in term and late preterm infants.
DESIGN
METHODS
Single-centre, non-blinded, exploratory randomised controlled trial.
SETTING
METHODS
A level-3 neonatal unit in a stand-alone paediatric hospital.
PATIENTS
METHODS
Infants born ≥34 weeks of gestation and ≤28 days, who needed PN. Eligible infants were randomised on day 1 or day 2 of admission.
INTERVENTIONS
METHODS
Early (day 1 or day 2 of admission, N=30) or late (day 6 of admission, N=30) PN.
MAIN OUTCOME MEASURES
METHODS
Plasma phenylalanine and F
RESULTS
RESULTS
The postnatal age at randomisation was similar between the groups (2.3 (SD 0.8) vs 2.3 (0.7) days, p=0.90). On day 4, phenylalanine levels in early-PN infants were higher than in late-PN (mean (SD) 62.9 (26.7) vs 45.5 (15.3) µmol/L; baseline-adjusted percentage difference 25.8% (95% CI 11.6% to 39.9%), p<0.001). There was no significant difference in phenylalanine levels between the two groups on day 8. There was no significant difference between the groups for F
CONCLUSIONS
CONCLUSIONS
The timing of the commencement of PN did not seem to affect the degree of oxidative stress in critically ill term and late preterm infants. The effect of transiently high plasma phenylalanine with early PN on clinical outcomes requires further investigation.
TRIAL REGISTRATION NUMBER
BACKGROUND
ACTRN12620000324910.
Identifiants
pubmed: 38735834
pii: 10.1136/bmjpo-2024-002579
doi: 10.1136/bmjpo-2024-002579
pii:
doi:
Substances chimiques
Phenylalanine
47E5O17Y3R
F2-Isoprostanes
0
Types de publication
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.