Effect of Early Parenteral Nutrition Discontinuation on Time to Regain Birth Weight in Very Low Birth Weight Infants: A Randomized Controlled Trial
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial
PubMed
30613992
DOI
10.1002/jpen.1502
Knihovny.cz E-resources
- Keywords
- PICC, enteral nutrition, parenteral nutrition, peripherally inserted central catheter, randomized controlled trial, regain birth weight, very low birth weight infant,
- MeSH
- Enteral Nutrition MeSH
- Weight Gain * MeSH
- Catheter-Related Infections * etiology prevention & control MeSH
- Humans MeSH
- Infant, Newborn, Diseases * etiology prevention & control MeSH
- Infant, Premature MeSH
- Infant, Very Low Birth Weight * MeSH
- Infant, Newborn MeSH
- Parenteral Nutrition adverse effects MeSH
- Catheterization, Peripheral MeSH
- Birth Weight * MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Infant, Newborn MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Randomized Controlled Trial MeSH
BACKGROUND: Peripherally inserted central catheters (PICCs) are used to administer parenteral nutrition (PN) in very low birth weight infants (VLBW; <1500 g). Clinicians try to optimize early nutrition but also minimize the risks associated with intravascular devices. The objective of this study was to examine the early nutrition impact of discontinuing PN at different enteral feed volumes in VLBW infants. METHODS: In this unmasked, multicenter, randomized controlled trial, patients were randomly assigned to PICC removal and PN discontinuation at an enteral feed volume of 100 mL/kg/day (intervention) or 140 mL/kg/day (control). Clinically stable VLBW infants with a PICC in situ who were receiving PN were eligible for inclusion. Infants with major congenital anomalies were excluded. A total of 139 patients were enrolled; 69 and 70 patients were randomized to the intervention and control groups, respectively. The primary outcome measure was the mean difference in time (days) to regain birth weight. RESULTS: The groups were well matched at study entry. Patients in the intervention group regained birth weight more slowly (mean difference 1.5 days CI: 0.3-2.7 days, P = 0.01). The mean difference in time to regain birth weight for infants <1000 g was 2.8 days (95% CI: 0.8-4.8 days, P = 0.008). CONCLUSIONS: In VLBW infants, early PICC removal at an enteral feed volume of 100 mL/kg/day compared with later removal at 140 mL/kg/day resulted in a significant delay in time to regain birth weight, and this delay was more pronounced in infants <1000 g.
3rd Faculty of Medicine Charles University Prague Czech Republic
Coombe Women and Infants University Hospital Dublin Ireland
Institute for the Care of Mother and Child Prague Czech Republic
National Maternity Hospital Dublin Ireland
Royal College of Surgeons in Ireland Dublin Ireland
The Hospital for Sick Children Toronto Canada
UCD School of Medicine University College Dublin Dublin Ireland
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ISRCTN
ISRCTN72413202