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  1. Garner, Sandra S. PharmD, BCPS, BCPPS, FCCP
  2. Cox, Toby H. PharmD, BCPS
  3. Safirstein, Julie PharmD, BCPS
  4. Groat, Erna K. PharmD, BCPPS
  5. Breznak, Katherine MS, RD, LDN, CNSC, CLC
  6. Taylor, Sarah N. MD


Background: Standardized parenteral nutrition (PN) formulations are used in at-risk neonates to provide nutrition immediately following birth. However, evidence for the optimal formulation(s) to maximize growth while reducing the risks of glucose and electrolyte abnormalities is limited.


Purpose: The purpose of this study was to compare the rates of hypernatremia and hyperglycemia with 2 weight-based standardized PN formulations versus one standard PN in low birth-weight preterm neonates.


Methods: This was a single-center observational study of infants less than 1800 g birth weight and less than 37 weeks' gestation who received standardized PN in the first 48 hours of life. Patients in the weight-based PN group were compared with a historical group of patients receiving single standard PN. Rates of hypernatremia and hyperglycemia were compared by [chi]2 analysis.


Results: There was a nonsignificant (P = .147) reduction in hypernatremia in the weight-based PN group (9 of 87; 10.3%) compared with the single PN group (16 of 89; 18.0%). However, hyperglycemia was significantly more frequent in the weight-based group than in the single PN group (24.1% vs 12.4%, P = .035).


Implications for Practice: The 2 weight-based PN standardized formulations studied did not significantly decrease the incidence of hypernatremia or hyperglycemia.


Implications for Research: Future studies to determine optimal standardized PN to provide early nutrition in high-risk neonates are warranted.