三腔袋用于早产儿的临床经验：对营养素摄入量和成本的影响
一种新型即用三腔袋（百特，迪尔菲尔德，伊利诺伊州）被用于早产儿肠外营养以提供欧洲儿科胃肠肝病营养学会（ESPGHAN）和欧洲临床营养代谢学会（ESPEN）儿科肠外营养指南推荐的营养素，故奥地利维也纳医科大学调查了早产儿（≤1600g）三腔袋对比个体化肠外营养的临床应用，并评价了对营养素摄入量、成本、配制时间的影响。
该临床观察研究通过新型处方软件制定早产儿处方，对个体化肠外营养与三腔袋处方进行镜像，对肠外营养的营养成分进行比较，并与ESPGHAN/ESPEN的推荐进行比较。此外，评定了成本和配制时间。
结果共对374例肠外营养液（333例＞1000g，41例≤1000g）进行了分析。三腔袋的蛋白质摄入量显著低于个体化肠外营养，不符合体重＜1500g婴儿出生后第一天和过渡时期的推荐量。三腔袋的能量摄入量显著较高。三腔袋的配制成本比个体化肠外营养高18欧元（大约20美元）。然而，三腔袋的配制时间快2分钟。
因此，当肠内喂养已经开始，三腔袋可以替代个体化肠外营养用于体重＞1000g婴儿稳定生长期间。三腔袋的蛋白质摄入量显著低于个体化肠外营养液。三腔袋与个体化肠外营养相比较贵，但是节省人力资源。
JPEN J Parenter Enteral Nutr. 2016;40(4):536-42.
Clinical Experience With Numeta in Preterm Infants: Impact on Nutrient Intake and Costs.
Kreissl A, Repa A, Binder C, Thanhaeuser M, Jilma B, Berger A, Haiden N.
Medical University of Vienna, Vienna, Austria.
BACKGROUND: A new "ready-to-use" triple-chamber container, Numeta (Baxter, Deerfield, IL), is available for preterm parenteral nutrition (PN) to provide nutrients according to the recommendations of the European Society for Pediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN) Guidelines for Pediatric Parenteral Nutrition. We investigated the clinical application of Numeta compared with individualized PN in preterm infants (≤1.500 g) and evaluated the effects on nutrient intake, costs, and preparation time.
MATERIALS AND METHODS: In a clinical observational study, prescriptions for preterm infants were performed with the new prescription software catoPAN (Cato Software Solutions, Becton Dickinson, Vienna, Austria). Individualized PN and Numeta prescriptions were mirrored, and nutrition content of the PNs was compared with each other and with ESPGHAN/ESPEN recommendations. Furthermore, costs and preparation time were assessed.
RESULTS: In total, 374 PN solutions (>1000 g [n = 333]/≤1000 g [n = 41]) were analyzed. Protein intake with Numeta was significantly lower compared with individualized PN and did not meet the recommendations for infants <1500 g during the first day and the period of transition after birth. Energy intake was significantly higher with Numeta. The costs for Numeta preparations were €18 (about US$20) higher than for individualized PN. However, the preparation time/solution was 2 minutes faster with Numeta.
CONCLUSION: Numeta is an alternative to individualized PN for infants >1000 g in the period of stable growth when enteral feedings have already started. Protein intake is significantly lower than in individualized PN solutions. Numeta is more expensive in comparison to individualized PN but saves human resources.
PMID: 25655621
DOI: 10.1177/0148607115569733
