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Prácticas de prescripción de nutrición parenteral neonatal en Portugal
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Orientador(es)
Resumo(s)
Introducción
La utilización de normas de orientación para la nutrición parenteral neonatal mejora la eficiencia y la seguridad de su prescripción.
Objetivo
Evaluar la práctica de prescripción de nutrición parenteral neonatal en Portugal y el cumplimiento del Consenso Nacional (2008).
Métodos
Encuesta de respuesta múltiple sobre la prescripción de nutrición parenteral (NP) enviada a los coordinadores de las 50 unidades de cuidados especiales neonatales portuguesas, tanto públicas como privadas, siendo 25 de nivel ii y 25 de nivel iii.
Resultados
Se prescribe NP en 32 unidades neonatales, habiendo 23 (71,9%) respondido la encuesta. De estas, 19 (82,6%) afirman tener como referencia el Consenso Nacional y las restantes siguen protocolos internos; 17 (73,9%) afirman preferir la prescripción mediante soporte informático. En recién nacidos pretérmino, la mayoría reporta una administración cautelosa de líquidos en la primera semana posnatal; inicio de aminoácidos desde el primer día posnatal con 1,5-3 g/kg/día y aumento hasta 3-4 g/kg/día; inicio de lípidos en los 3 días posnatales con 1 g/kg/día y aumento hasta 3 g/kg/día; administración de 40-70 mg/kg/día de calcio y fósforo, con un ratio calcio:fósforo de 1,7:1 (mg:mg), y estimación de la osmolaridad de las soluciones y control semanal de la trigliceridemia, uremia, fosforemia y función hepática.
Conclusiones
Por la elevada tasa de respuesta la muestra probablemente es representativa de la práctica de prescripción de nutrición parenteral neonatal en Portugal. La mayoría de las unidades tienen como referencia el Consenso Nacional, lo que contribuye a unos mejores cuidados de los recién nacidos.
Introduction The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription. Objective To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008). Methods A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II. Results Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3 g/kg/d, increasing up to 3-4 g/kg/d; starting lipids from the first three post-natal days with 1 g/kg/d, increasing up to 3 g/kg/d; administering 40-70 mg/kg/d of calcium and of phosphorus with the fixed calcium:phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function. Conclusions The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates.
Introduction The use of guidelines for neonatal parenteral nutrition (PN) improves its clinical efficiency and the safety of prescription. Objective To evaluate the practices of neonatal parenteral nutrition prescription in Portugal, and the adherence to the National Consensus on neonatal PN (2008). Methods A questionnaire based on a multiple choice response on parenteral nutrition prescription was conducted, and sent to the coordinators of the 50 public and private Portuguese neonatal special care units, 25 being level III and 25 level II. Results Parenteral nutrition was prescribed in 32 neonatal units, 23 of which (71.9%) responded to the questionnaire. Of the respondents, 19 (82.6%) refer to follow the National Consensus, the remaining following local guidelines; 17 (73.9%) of units referred to using an electronic based system for prescription. In preterm neonates, most mentioned: administering judiciously the fluid intake during the first post-natal week; starting amino acids from the first post-natal day with 1.5-3 g/kg/d, increasing up to 3-4 g/kg/d; starting lipids from the first three post-natal days with 1 g/kg/d, increasing up to 3 g/kg/d; administering 40-70 mg/kg/d of calcium and of phosphorus with the fixed calcium:phosphorus ratio of 1.7: 1 (mg:mg); and estimating the osmolality of the solutions, and weekly monitoring of serum triglycerides, blood urea, serum phosphorus and liver function. Conclusions The high response rate is probably representative of the practice of PN prescription in Portugal. Most of the units used the National Consensus on neonatal PN as a reference, thus contributing to better nutritional support for neonates.
Descrição
Palavras-chave
Nutrición parenteral neonatal Prescripción Portugal
Contexto Educativo
Citação
Neves, Andrea; Pereira da Silva, Luis; Fernandez-Llimos, Fernando. [Neonatal parenteral nutrition prescription practices in Portugal], AN PEDIATR, 80, 2, 98-105, 2014.