摘要
The objective of this study was to monitor and evaluate the rationall of total parenteral nutrition support for hospitalized preterm infants in order to set up the monitoring guidelines to improve the nutrition support care (NSC) in the future routines. Firstly, we monitored and documented 23 preterm infants (12M, 11F) in the NICU (Neonatal Intensive Care Unit) who were supported with parenteral nutrition solutions (TPNs) during the period of Nov. 21, 2002 to Feb. 20, 2003 (3 months). Then, retrieved the relevant data from the charts and electronic medical records via the e-Hospital website of NTUH. We also examined the laboratory data, progress note, keyed in an Excel sheet and discussed with the on-duty nurses and residents to clarify the NSC outcome for the specific patient. Furthermore, we evaluated TPNs against the corresponding patients' complications and underlying disorders. Among these 23 cases collected, 91.3% were born with low to extremely low birth weight and administered TPNs for 4-64 days and fed well till discharge. The percentage of cases who used TPNs to provide nutrients that respectively met the recommended daily allowance and requirements (RDA) were 69.6% for individual total calories, 91.3% (for dextrose), 95.7% (for amino acids), 78.3%(for lipids). During NSC, 30.4% and 43.5% of the cases decreased serum phosphate and serum sodium respectively to abnormal level. Also, 30.4% of these cases increased their serum chloride to higher than 108 mmol/L. The incidence of complications increased 21.7%, 12.7%, 21.7% and 21.7% respectively for elevation of SGOT, SGPT, T-Bil, and D-Bil. Thus, it is necessary to closely monitor, evaluate and modulate the TPNs formula for the preterm newborns during TPN support to prevent complications and to further improve the patient safety and quality of care as well.
並列摘要
The objective of this study was to monitor and evaluate the rationall of total parenteral nutrition support for hospitalized preterm infants in order to set up the monitoring guidelines to improve the nutrition support care (NSC) in the future routines. Firstly, we monitored and documented 23 preterm infants (12M, 11F) in the NICU (Neonatal Intensive Care Unit) who were supported with parenteral nutrition solutions (TPNs) during the period of Nov. 21, 2002 to Feb. 20, 2003 (3 months). Then, retrieved the relevant data from the charts and electronic medical records via the e-Hospital website of NTUH. We also examined the laboratory data, progress note, keyed in an Excel sheet and discussed with the on-duty nurses and residents to clarify the NSC outcome for the specific patient. Furthermore, we evaluated TPNs against the corresponding patients' complications and underlying disorders. Among these 23 cases collected, 91.3% were born with low to extremely low birth weight and administered TPNs for 4-64 days and fed well till discharge. The percentage of cases who used TPNs to provide nutrients that respectively met the recommended daily allowance and requirements (RDA) were 69.6% for individual total calories, 91.3% (for dextrose), 95.7% (for amino acids), 78.3%(for lipids). During NSC, 30.4% and 43.5% of the cases decreased serum phosphate and serum sodium respectively to abnormal level. Also, 30.4% of these cases increased their serum chloride to higher than 108 mmol/L. The incidence of complications increased 21.7%, 12.7%, 21.7% and 21.7% respectively for elevation of SGOT, SGPT, T-Bil, and D-Bil. Thus, it is necessary to closely monitor, evaluate and modulate the TPNs formula for the preterm newborns during TPN support to prevent complications and to further improve the patient safety and quality of care as well.