Parenteral Nutrition Objectives for Very Low Birth Weight Infants: Results of a National Survey

Objectives: The aim of the study was to evaluate parenteral nutrition objectives for very low birth weight (VLBW) infants in neonatal intensive care units (NICUs), and to compare nutritional protocol differences according to levels of care. Materials and Methods: A national survey was conducted in France through a questionnaire sent to 296 French neonatal departments to determine each team leader's nutritional objectives for parenteral nutrition of VLBW infants. Results: A total of 172 of the 296 French neonatal departments responded to the questionnaire. Protein administration was not started during the first day of life in half of the responding units. Furthermore, half of the units initiated protein administration with less than 1 g.kg(-1) . day(-1). The day of introduction of lipid emulsions varied considerably from one unit to another, but more than half of the units started the lipid emulsions after the third day of life. Twenty percent of the units reported a target energy intake of 100 kcal . kg(-1) . day(-1), whereas 14% reported a target intake above or equal to 130 kcal . kg(-1) day(-1). Conclusions: In comparison with recent guidelines for parenteral nutrition for VLBW infants, the results indicate that the majority of the departments are familiar with target macronutrient and energy intakes, but the time of introduction and the rate of progression of macronutrients, particularly proteins and lipids, are frequently lower than those defined by the guidelines. The large-scale publication of new nutritional guidelines for the parenteral nutrition of neonates and preterm infants as well as regular, specific training in the parenteral nutrition of preterm infants are needed. JPGN 48:618-626, 2009.