Improved Macro- and Micronutrient Supply for Favorable Growth and Metabolomic Profile with Standardized Parenteral Nutrition Solutions for Very Preterm Infants
Alida Kindt,
Yvonne Kraus,
David Rasp,
Kai M. Foerster,
Narges Ahmidi,
Andreas W. Flemmer,
Susanne Herber-Jonat,
Florian Heinen,
Heike Weigand,
Thomas Hankemeier,
Berthold Koletzko,
Jan Krumsiek,
Juergen Babl,
Anne Hilgendorff
Affiliations
Alida Kindt
Institute of Computational Biology, Helmholtz Zentrum München, 85764 Oberschleißheim, Germany
Yvonne Kraus
Center for Comprehensive Developmental Care (CDeCLMU), Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr von Hauner Children's Hospital, Munich University Hospital, Ludwig Maximilians University, 80336 Munich, Germany
David Rasp
Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, 2333 AL Leiden, The Netherlands
Kai M. Foerster
Comprehensive Pneumology Center, Helmholtz Zentrum München, Member of the German Lung Research Center (DZL), 81377 Munich, Germany
Narges Ahmidi
Institute of Computational Biology, Helmholtz Zentrum München, 85764 Oberschleißheim, Germany
Andreas W. Flemmer
Department of Neonatology, Perinatal Center, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians University, 80337 Munich, Germany
Susanne Herber-Jonat
Department of Neonatology, Perinatal Center, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians University, 80337 Munich, Germany
Florian Heinen
Center for Comprehensive Developmental Care (CDeCLMU), Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr von Hauner Children's Hospital, Munich University Hospital, Ludwig Maximilians University, 80336 Munich, Germany
Heike Weigand
Center for Comprehensive Developmental Care (CDeCLMU), Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr von Hauner Children's Hospital, Munich University Hospital, Ludwig Maximilians University, 80336 Munich, Germany
Thomas Hankemeier
Metabolomics and Analytics Center, Leiden Academic Centre for Drug Research, Leiden University, 2333 AL Leiden, The Netherlands
Berthold Koletzko
Division of Metabolic and Nutritional Medicine, Department of Paediatrics, Dr. von Hauner Children’s Hospital University Hospital, Ludwig-Maximilians University, 81377 Munich, Germany
Jan Krumsiek
Institute of Computational Biology, Helmholtz Zentrum München, 85764 Oberschleißheim, Germany
Juergen Babl
Pharmacy of the University Hospital, Ludwig-Maximilians University, 81377 Munich, Germany
Anne Hilgendorff
Center for Comprehensive Developmental Care (CDeCLMU), Division of Pediatric Neurology, Developmental Medicine and Social Pediatrics, Department of Pediatrics, Dr von Hauner Children's Hospital, Munich University Hospital, Ludwig Maximilians University, 80336 Munich, Germany
Very preterm infants are at high risk for suboptimal nutrition in the first weeks of life leading to insufficient weight gain and complications arising from metabolic imbalances such as insufficient bone mineral accretion. We investigated the use of a novel set of standardized parenteral nutrition (PN; MUC PREPARE) solutions regarding improving nutritional intake, accelerating termination of parenteral feeding, and positively affecting growth in comparison to individually prescribed and compounded PN solutions. We studied the effect of MUC PREPARE on macro- and micronutrient intake, metabolism, and growth in 58 very preterm infants and compared results to a historic reference group of 58 very preterm infants matched for clinical characteristics. Infants receiving MUC PREPARE demonstrated improved macro- and micronutrient intake resulting in balanced electrolyte levels and stable metabolomic profiles. Subsequently, improved energy supply was associated with up to 1.5 weeks earlier termination of parenteral feeding, while simultaneously reaching up to 1.9 times higher weight gain at day 28 in extremely immature infants (<27 GA weeks) as well as overall improved growth at 2 years of age for all infants. The use of the new standardized PN solution MUC PREPARE improved nutritional supply and short- and long-term growth and reduced PN duration in very preterm infants and is considered a superior therapeutic strategy.