Photoprotection of Parenteral Nutrition Enhances Advancement of Minimal Enteral Nutrition in Preterm Infants

Khashu, Minesh; Harrison, Adele; Lalari, Vikki; Gow, Andrew; Lavoie, Jean-Claude; Chessex, Philippe

doi:10.1053/j.semperi.2006.04.007

« Previous Next »Seminars in Perinatology
Volume 30, Issue 3 , Pages 139-145, June 2006

Photoprotection of Parenteral Nutrition Enhances Advancement of Minimal Enteral Nutrition in Preterm Infants

Minesh Khashu, MD
- Division of Neonatology, Children’s and Women’s Health Centre of British Columbia, University of British Columbia, Vancouver, BC, Canada.
Adele Harrison, MD
- Division of Neonatology, Children’s and Women’s Health Centre of British Columbia, University of British Columbia, Vancouver, BC, Canada.
Vikki Lalari, MSc, Rd
- Nutrition Services, Children’s and Women’s Health Centre of British Columbia, University of British Columbia, Vancouver, BC, Canada.
Andrew Gow, PhD
- Children’s Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA.
Jean-Claude Lavoie, PhD
- Department of Pediatrics, Hôpital Sainte-Justine, University of Montreal, Montreal, QC, Canada.
Philippe Chessex, MD
- Division of Neonatology, Children’s and Women’s Health Centre of British Columbia, University of British Columbia, Vancouver, BC, Canada.
- Address reprint requests to Philippe Chessex, MD, Division of Neonatology, Childrens’ and Womens’ Health Centre, 4480 Oak Street, Vancouver, BC, V6H 3V4, Canada.

Background

Light exposure of TPN generates peroxides which induce vasoconstriction. Mesenteric vasoconstriction may affect feeding tolerance. Since photo-protection of TPN decreases peroxide generation, we hypothesized that shielding TPN from light may improve the establishment of minimal enteral nutrition in preterm infants.

Methods

Infants were randomized to TPN being light exposed (LE) or protected (LP) from birth. Feeding volumes were monitored through 7 days of life in those initiated on minimal enteral nutrition (MEN). Comparisons between LP and LE were performed by ANOVA.

Results

Daily increments and cumulative volumes of enteral feeds (mL/kg birth weight/d) during the first week of life were significantly higher in LP (n = 18) than LE (n = 19).

Conclusion

Photo-protection of parenteral nutrition enhances advancement of MEN in preterm infants. Further research is needed to substantiate these findings and determine whether this confers long-term nutritional advantages.

Keywords: newborn , parenteral nutrition , photoprotection , peroxides , minimal enteral nutrition