ESPEN 2011 Late breaking abstract submission

Topic: Late Breaking Abstract

Abs n°:ESPEN11-2125

Abs Title: PARENTERAL NUTRITION PRESCRIBING PATTERNS IN GERMANY: A MEDICAL CHART REVIEW OF 191 PRETERM INFANTS

F. X. Liu ¹G. M. Prinz ²C. Macahilig ²F. Malinoski ²R. S. Turpin ^{1 3,*}

¹Global Health Economics, BAXTER HEALTHCARE, Deerfield, ²Medical Data Analytics, Parsippany, ³Public Policy, Thomas Jefferson Hospital, Philadelphia, United States

Rationale: Parenteral nutrition (PN) is vital for preterm infants (PI) when they are unable to tolerate oral or enteral feeding during their earliest growth period.  The European Society for Clinical Nutrition and Metabolism (ESPEN) has developed guidelines for paediatric PN based on limited data. This study compared PI parenteral nutrition prescribing patterns in Germany to ESPEN guideline recommendations.

Methods: An observational retrospective medical chart review was conducted in early 2011 across Germany. Six neonatologists representing 6 diverse institutions collected data on 191 PIs. PIs were included if they received PN for ≥4 days and excluded if they died within 3 days of life, or were transferred to/from another facility.  Patient demographics, hospitalization characteristics, and PN prescribing patterns were collected. PN prescribing patterns were compared with the ESPEN guideline recommendations on the intake of amino acids (AA) and lipids.

Results: Data abstracted were from 95 male and 96 female PIs with an average gestational age of 31.4 weeks (SD, 3.0 weeks) & birth weight of 1518g (SD, 454g). During the 1st 24 hours of life, 85% of PIs received PN.  Among those receiving PN, 100% received glucose, but only 2% of PIs received the recommended levels of lipids and AA.  Over the next 6 days, the mean lipid level achieved was 1.6 g/kg/day (recommended maximum 4.0 g/kg/day), with a mean AA level achieved of 2.4 g/kg/day (recommended maximum 4.0 g/kg/day).

Conclusion: This retrospective chart review provides important data on the real-world use of PN among preterm infants in Germany.   Compared to ESPEN guidelines, PIs may not receive the recommended levels of AA and lipids, particularly during their 1st 24 hours of life.

Disclosure of Interest: F. X. Liu Other: Employee of Baxter HealthcareG. M. Prinz Consultant for: Baxter HealthcareC. Macahilig Consultant for: Baxter HealthcareF. Malinoski Consultant for: Baxter HealthcareR. Turpin Other: Employee of Baxter Healthcare

Keywords: parenteral nutritionPreterm