Sjoerd C J Nagelkerke1, Cora F Jonkers-Schuitema1, Wendy L M Kastelijn2, Anne-Loes E Gerards3, Marc A Benninga1, Barbara A E de Koning2, Merit M Tabbers1. 1. Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, University of Amsterdam, Amsterdam UMC, Amsterdam. 2. Erasmus Medical Center, Department of Pediatric Gastroenterology, Sophia Children's Hospital, Erasmus University Rotterdam, Rotterdam. 3. Department of Hospital Pharmacy, University of Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.
Abstract
OBJECTIVES: Studies evaluating efficacy or safety of standardized parenteral nutrition (PN) versus individualized PN are lacking. We aimed to assess effects on growth and safety of standardized PN compared with individualized PN in our Home PN group. METHODS: Descriptive cohort study in Dutch children on Home PN, in which standardized PN was compared with individualized PN. Both groups received similar micronutrient-supplementation. Primary outcome was growth over 2 years, secondary outcomes were electrolyte disturbances and biochemical abnormalities. Additionally, patients were matched for age to control for potential confounding characteristics. RESULTS: Fifty patients (50% girls, median age 6.5 years) were included, 16 (32%) received standardized PN mixtures. Age (11 vs 5 years), gestational age (39.2 vs 36.2 weeks) and PN duration (97 vs 39 months) were significantly higher in the group receiving standardized PN (P: ≤0.001; 0.027; 0.013 respectively). The standardized PN group showed an increase in weight-for-age (WFA), compared with a decrease in the individualized PN group (+0.38 SD vs -0.55 SD, P: 0.003). Electrolyte disturbances and biochemical abnormalities did not differ. After matching for age, resulting in comparable groups, no significant differences were demonstrated in WFA, height-for-age, or weight-for-height SD change. CONCLUSIONS: In children with chronic IF, over 2,5 years of age, standardized PN mixtures show a comparable effect on weight, height, and weight for height when compared with individualized PN mixtures. Also, standardized PN mixtures (with added micronutrients) seem noninferior to individualized PN mixtures in terms of electrolyte disturbances and basic biochemical abnormalities. Larger studies are needed to confirm these conclusions. TRIAL REGISTRATION: Academical Medical Center medical ethics committee number W18_079 #18.103.
OBJECTIVES: Studies evaluating efficacy or safety of standardized parenteral nutrition (PN) versus individualized PN are lacking. We aimed to assess effects on growth and safety of standardized PN compared with individualized PN in our Home PN group. METHODS: Descriptive cohort study in Dutch children on Home PN, in which standardized PN was compared with individualized PN. Both groups received similar micronutrient-supplementation. Primary outcome was growth over 2 years, secondary outcomes were electrolyte disturbances and biochemical abnormalities. Additionally, patients were matched for age to control for potential confounding characteristics. RESULTS: Fifty patients (50% girls, median age 6.5 years) were included, 16 (32%) received standardized PN mixtures. Age (11 vs 5 years), gestational age (39.2 vs 36.2 weeks) and PN duration (97 vs 39 months) were significantly higher in the group receiving standardized PN (P: ≤0.001; 0.027; 0.013 respectively). The standardized PN group showed an increase in weight-for-age (WFA), compared with a decrease in the individualized PN group (+0.38 SD vs -0.55 SD, P: 0.003). Electrolyte disturbances and biochemical abnormalities did not differ. After matching for age, resulting in comparable groups, no significant differences were demonstrated in WFA, height-for-age, or weight-for-height SD change. CONCLUSIONS: In children with chronic IF, over 2,5 years of age, standardized PN mixtures show a comparable effect on weight, height, and weight for height when compared with individualized PN mixtures. Also, standardized PN mixtures (with added micronutrients) seem noninferior to individualized PN mixtures in terms of electrolyte disturbances and basic biochemical abnormalities. Larger studies are needed to confirm these conclusions. TRIAL REGISTRATION: Academical Medical Center medical ethics committee number W18_079 #18.103.
Authors: Antonella Lezo; Antonella Diamanti; Evelyne M Marinier; Merit Tabbers; Anat Guz-Mark; Paolo Gandullia; Maria I Spagnuolo; Sue Protheroe; Noel Peretti; Laura Merras-Salmio; Jessie M Hulst; Sanja Kolaček; Looi C Ee; Joanna Lawrence; Jonathan Hind; Lorenzo D'Antiga; Giovanna Verlato; Ieva Pukite; Grazia Di Leo; Tim Vanuytsel; Maryana K Doitchinova-Simeonova; Lars Ellegard; Luisa Masconale; María Maíz-Jiménez; Sheldon C Cooper; Giorgia Brillanti; Elena Nardi; Anna S Sasdelli; Simon Lal; Loris Pironi Journal: Nutrients Date: 2022-04-30 Impact factor: 6.706
Authors: Mark J Johnson; Alexandre Lapillonne; Jiri Bronsky; Magnus Domellof; Nicholas Embleton; Silvia Iacobelli; Frank Jochum; Koen Joosten; Sanja Kolacek; Walter A Mihatsch; Sissel J Moltu; John W L Puntis; Arieh Riskin; Raanan Shamir; Merit M Tabbers; Johannes B Van Goudoever; Miguel Saenz de Pipaon Journal: Pediatr Res Date: 2021-09-02 Impact factor: 3.953