Pediatr. praxi. 2024;25(3):152-156 | DOI: 10.36290/ped.2024.031
Parenteral nutrition in neonatology III - critically ill newborn
- 1 Ústav pro péči o matku a dítě - Neonatologie, Praha
- 2 3. lékařská fakulta Univerzity Karlovy, Praha
- 3 The European Society for Paediatric Gastroenterology Hepatology and Nutrition (ESPGHAN), Geneva, Švýcarsko
The strategy for parenteral nutrition in critically ill neonates fundamentally differs from that in stable patients. The optimal intake of macronutrients and energy depends on the individual phases of the disease, which can be distinguished by the dynamics of changes in biomarkers and the level of cardiopulmonary support provided. In the acute phase, endogenous lipolysis and proteolysis occur, which is relatively independent of the exogenous nutrient supply. Catabolism of fat and muscle tissue (substrate formation for gluconeogenesis) along with glycogenolysis causes hyperglycemia, to which insulin resistance and parenteral nutrition also contribute. Monitoring and optimizing the intake of macronutrients and energy in this stage allow for the prevention of serious complications (overfeeding). During the anabolic phase, it is necessary to significantly increase the nutritional intake to cover the cumulative nutritional deficit and support tissue regeneration (prevention of underfeeding).
Keywords: parenteral nutrition, critically ill newborn, overfeeding, underfeeding.Úvod
Accepted: June 12, 2024; Published: June 14, 2024 Show citation
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