Observational studyPloS one2017
Early optimal parenteral nutrition and metabolic acidosis in very preterm infants.
Observational study in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 33 citations in OpenAlex.
- Association between base excess levels and clinical outcomes among very low birth weight infants: a multicenter birth cohort study in South Korea.Clinical and experimental pediatrics · 2026Article
- Controversies in Parenteral Protein Intake in Preterm Infants.Children (Basel, Switzerland) · 2025Review
- Uncovering Diaphragm Cramp in SIDS and Other Sudden Unexpected Deaths.Diagnostics (Basel, Switzerland) · 2024Article
- Association between early metabolic acidosis and bronchopulmonary dysplasia/death in preterm infants born at less than 28 weeks' gestation: an observational cohort study.BMC pediatrics · 2024Observational
- Proactive Use of a Human Milk Fat Modular in the Neonatal Intensive Care Unit: A Standardized Feeding Protocol.Nutrients · 2024Article
- Early Energy Intake and Amino Acid Profile in Preterm Newborns: A Quasi-Experimental Study.Nutrients · 2023Article
- Macronutrients and Micronutrients in Parenteral Nutrition for Preterm Newborns: A Narrative Review.Nutrients · 2022Review
- Early Enteral Feeding Improves Tolerance of Parenteral Nutrition in Preterm Newborns.Nutrients · 2021Observational
- Effects of early energy intake on neonatal cerebral growth of preterm newborn: an observational study.Scientific reports · 2021Observational
- Neonatal Hyperglycemia Related to Parenteral Nutrition Affects Long-Term Neurodevelopment in Preterm Newborn: A Prospective Cohort Study.Nutrients · 2021Article
- Intravenous Lipid Emulsions Affect Respiratory Outcome in Preterm Newborn: A Case-Control Study.Nutrients · 2021Article
- Use of intravenous sodium bicarbonate in neonatal intensive care units in Italy: a nationwide survey.Italian journal of pediatrics · 2021Article
- Sex Affects Human Premature Neonates' Blood Metabolome According to Gestational Age, Parenteral Nutrition, and Caffeine Treatment.Metabolites · 2021Article
- Renal aspects of metabolic acid-base disorders in neonates.Pediatric nephrology (Berlin, Germany) · 2020Review
- Long-term effects on growth of an energy-enhanced parenteral nutrition in preterm newborn: A quasi-experimental study.PloS one · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is currently recognized that an optimized nutritional approach, consisting of an early and substantial supply of protein and energy by parenteral route, may be beneficial for very low birth weight infants and recent guidelines endorse this strategy. However, the impact of the enhanced parenteral nutrition (PN) on acid-basic balance has never been investigated. The aim of the present study is to assess the effect of nutrient intake on acid-base homeostasis in a large population of preterm infants on PN.
methodsThis observational study described the acid-base profile of very preterm infants (≤29 week's gestation) receiving PN during the first week of life. For this purpose three different cohorts of infants who received increasing (group 1 to group 3) nutritional intakes were considered. Nutrition data were recorded daily and correlated to acid-base data (pH, base excess, and lactate). The outcome measure to assess metabolic acidosis was the base excess (BE).
results161 infants were included. 1127 daily nutritional records and 795 blood gas data were analyzed. The three groups were different with regard to nutritional intravenous intakes. Group 3 in particular had a higher mean intake of both amino acids (3.3 ± 0.8 g/kg/d) and lipids (2.8 ± 1.4 g/kg/d) during the first week of life. Metabolic acidosis was more severe in the group with the highest parenteral intake of amino acids and lipids: mean BE = -8.7 ± 3.4 (group 3); -6.4 ± 3.4 (group 2); -5.1 ± 3.0 (group 1)]. At the multivariate analysis the significant risk factors for metabolic acidosis were: gestational age, initial base excess, amino acid and lipid intravenous intakes. DISCUSSION: Acid-base homeostasis was influenced by the nutritional intake. Earlier and higher intravenous amino acid and lipid intakes particularly increased the risk of metabolic acidosis. The nutritional tolerance was different depending on gestational age, and the smaller infants (24-26 week's gestation) displayed greater acidotic disequilibrium and a higher need of bicarbonate.
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