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Standardised neonatal parenteral nutrition formulations - Australasian neonatal parenteral nutrition consensus update 2017

Bolisetty S 1 , Osborn D 2 , Schindler T 3 , Sinn J 4 , Deshpande G 5 , Wong CS 6 Show all authors , Jacobs SE 7 , Phad N 8 , Pharande P 9 , Tobiansky R 10 , Luig M 11 , Trivedi A 12 , Mcintosh J 8 , Josza E 13 , Opie G 14 , Downe L 5 , Andersen C 15 , Bhatia V 15 , Kumar P 16 , Malinen K 17 , Birch P 18 , Simmer K 19 , McLeod G 20 , Quader S 21 , Rajadurai VS 22 , Hewson MP 23 , Nair A 24 , Williams M 9 , Xiao J 25 , Ravindranathan H 26 , Broadbent R 27 , Lui K 28

Affiliations 

  • 1 Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia. [email protected]
  • 2 Royal Prince Alfred Hospital, Sydney, Australia
  • 3 Royal Hospital for Women, University of New South Wales, Sydney, Australia
  • 4 University of Sydney, Sydney, Australia
  • 5 Nepean Hospital, Sydney, Australia
  • 6 Hospital Kuala Lumpur, Kuala Lumpur, Malaysia
  • 7 Deputy Clinical Director and Neonatal Paediatrician, The Royal Women's Hospital, Parkville, Victoria, Australia
  • 8 John Hunter Children's Hospital, Newcastle, Australia
  • 9 Monash Children's Hospital, Clayton, Victoria, Australia
  • 10 Liverpool Hospital, Sydney, Australia
  • 11 Westmead Hospital, Sydney, Australia
  • 12 The Children's Hospital at Westmead, Sydney, Australia
  • 13 Royal Hospital for Women, Locked Bag 2000, Randwick NSW, Sydney, 2031, Australia
  • 14 Head and Neonatal Paediatrician, Mercy Hospital for Women, Heidelberg, Victoria, Australia
  • 15 Head of Neonatology, Women's and Children's Hospital, North Adelaide, Australia
  • 16 Townsville Hospital, Townsville, Australia
  • 17 PGCert Clinical Education, PGDip Child Health (associate), Advanced Pharmacist, Townsville Hospital, Townsville, Australia
  • 18 Gold Coast University Hospital, Southport, Australia
  • 19 King Edward Memorial Hospital for Women, Subiaco, Australia
  • 20 King Edward Memorial and Princess Margaret Hospitals, Subiaco, Australia
  • 21 The Sydney Children's Hospital Network, Sydney, Australia
  • 22 Department of Neonatology, KK Women's and Children's Hospital, Kampong Java, Singapore
  • 23 Wellington Hospital, Wellington South, New Zealand
  • 24 Waikato Hospital, Hamilton, New Zealand
  • 25 Nepean Hospital, Penrith, Australia
  • 26 Paediatric Intensivist, Sydney Children's Hospital, Sydney, Australia
  • 27 Dunedin School of Medicine, Dunedin, New Zealand
  • 28 University of New South Wales, Sydney, Australia
BMC Pediatr, 2020 02 08;20(1):59.
PMID: 32035481 DOI: 10.1186/s12887-020-1958-9

Abstract

BACKGROUND: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines.

METHODS: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed.

RESULTS: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed.

CONCLUSIONS: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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