STANDARD 2-COMPARTMENT FORMULATION FOR TOTAL PARENTERAL-NUTRITION IN THE NEONATAL INTENSIVE-CARE UNIT - A FLUID TOLERANCE BASED SYSTEM

The nutrient requirements of most (pre) term newborns receiving intens ive care appear to be relatively fixed. The range of optimal fluid loa d however, is perceived as being quite narrow and highly variable in t ime. We designed four amino acid-dextrose mixtures for a standardized neonatal-parenteral nutrition, delivering a fixed amount of nutrients in four dilutions with water and corresponding to a fluid load of 90, 110, 130 or 170 ml/kg per day. The addition of a lipid emulsion comple tes the TPN. In a pilot study, we followed the weight of 30 very low b irthweight infants on this parenteral nutrition. After a stabilisation period, the weight gain was found to be similar to the normal fetal w eight accretion in utero. We have now infused these solutions in to mo re than 1000 infants, without significant complications. These formula tions proved to have substantial advantages compared to the individual ized prescription in terms of availability, safety and time- and cost- effectiveness.