1019 Standardized Versus Individualized Parenteral Nutrition in Very-Low-Birth-Weight Infants: A Comparative Study

Background:Parenteral nutrition (PN) improves growth and outcome of very-low-birth-weight (VLBW) infants. Optimal PN composition, standard (STD-PN) or individualized (IND-PN), is still controversial. Aim: To compare IND-PN and STD-PN as to nutritional and growth parameters, complications and cost. Patients and Methods: 140 VLBW infants were studied. Each of the 70 neonates from the INDPN group was matched with a neonate of similar gestational age (GA) (± 4 days) on STD-PN. Data collection included demographic, maternal, intrapartum, neonatal, interventional, growth and nutritional data. Results: Compared to STD-PN infants, INDPN infants had a significantly lower mean birth weight, greater need for resuscitation at birth and interventions thereafter. Nevertheless, IND-PN infants showed significantly greater weight-gain SDS during the 1st week (p=0.036) and the 1st month of life (p=0.0004), and higher dischargeweight SDS (p=0.012) and head-circumference SDS (p=0.006). IND-PN infants received higher mean daily caloric intakes. They also had significantly shorter durations of exclusive PN and needed less electrolyte corrections. Conclusions: Compared to STD-PN infants, INDPN infants achieved significantly better growth without added clinical or laboratory complications, had shorter period of exclusive PN and less electrolyte corrections. IND-PN, in accordance with the current more aggressive nutritional approach, appears optimal for PN of VLBW infants. Yet, STDPN with adequate composition is an appropriate alternative.