4CPS-189 Adequacy of the prescription of parenteral nutrition in neonatology

BackgroundNowadays, there is a stronger consensus on the proceedings of nutritional support with parenteral nutrition (PN) in paediatrics and nutritional requirements in order to improve the process quality and the patient’s safety.PurposeReview the prescriptions of PN to identify the degree of adherence to the available evidence (Clinical Practice Guide SENPE/SEGHNP/SEFH 2017) and propose areas for improvement.Material and methodsRetrospective study of newborn patients who received PN during 2017 in the area of neonatology in our hospital.Patients divided according to the age ranges established by the guidelines: preterm newborn (RNPT) and term newborns under 1 month (RNAT).Variables: contributions of macronutrients (aminoacids, glucose, lipids), micronutrients (sodium, potassium, phosphorus, calcium), volume/kg and caloric requirements.Data collected from PN elaboration program, Nutriwin, treated in Excel.ResultsOne-hundred and seventy-nine RNPT and 2,429 PNs were prepared and validated. Aminoacids (aa): 96.8% of PNs met the recommended requirements (3–4 g/kg/day). Carbohydrates (CH): 85.4% were adjusted and 13.4% were above the recommendations (6–12 g/kg/day). The limit of CH (16–18 g/kg/day) was not exceeded. Lipids: they did not exceed the maximum limit (3–4 g/kg/day). Sodium (Na) and potassium (K): 82.69% and 93.03% met the recommended requirements respectively (3–5 mEq/kg/day and 2–5 (mEq/kg/day); phosphate (P): 23% within the recommended limits (1.45–2.25 (mM/g/day), 64.47% above; and calcium (Ca): 80.44% within the recommended range (3–4 mEq/kg/day). Recommended volume (140 ml/kg/day): 7.96% on range, 92.04% below. kcal/kg: in 95.5% of patients increased compared to that recommended on the first day (60 kcal/kg/day); and 90% of patients were below the recommended level in the third week (120 kcal/kg/day).RNAT under 1 month: 24 patients and 248 NPs. aa: 43.54% met the requirements (2.3–3), exceeding 43.14%. HC and lipids: 100% within the limits (16–18 and 3–4 respectively). Na: 71.79% within the recommended range (2–3); K: 66.49% within the recommended range (1.5–3); 33.5% above; P: 39.5% met the recommendations (1–1.5), 24.5% below, 36% above; and Ca: 75.40% on range (2–3). Volume ml/kg: 90.38% lower than recommended (140 ml/kg/day). Energy requirements: 83.33% of patients lower than recommended (110 kcal/kg).ConclusionWe consider an acceptable degree of adequacy to the published recommendations regarding macronutrient inputs and caloric distribut