Postnatal growth failure in preterm infants remains a reason of concern for the Neonatologist because it has been associated with poor outcomes, such as neurodevelopment. Nutrition is key for a proper infant growing and continuous improvements, especially for small preterm infants, are in place. In preterm infants with a low birth weight, bridging parenteral nutrition is a life-saving therapy and it is recommended from the first hours of life to reduce the risk of postnatal growth failure. However, it has often been associated with metabolic complications. The aims of this thesis were to study the effect of the intravenous lipid emulsions on short- and long-term outcomes and to find factors associated to hypertriglyceridemia and elevated blood urea concentration in preterm infants on bridging parenteral nutrition. Study patients were preterm infants with a birth weight of less than 1250g on bridging parenteral nutrition from birth, born between 2004 and 2018. Preterm infants were able to tolerate markedly lower intravenous lipid intakes than the recommended target values of 2018 Parenteral Nutrition Guidelines and the low gestational age was associated both with hypertriglyceridemia and elevated blood urea. Infants with hypertriglyceridemia did not show significantly higher complications, worser growth and neurodevelopment than non-hypertriglyceridemic infants. Furthermore, intravenous lipid emulsions did not significantly affect neither lung growth nor neurodevelopment. In conclusion, this thesis provides novel information on the management of bridging parenteral nutrition in the small preterm infant, pointing out the importance of the high standard of care for newborns admitted to the neonatal intensive unit care.
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.