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Similar a Nutrition Support Special Considerations For Nenaotes
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Nutrition Support Special Considerations For Nenaotes
- 1. Nutrition Support Special Considerations in Neonates Sajjad Ahmad RPh. BCNSP TPN Pharmacist, In-Charge IV Admixture Services KFSH&RC Jeddah K.S.A (May 2009)
- 2. 2
- 3. Defining Neonates In Terms Of Weight 3
- 4. Nutrition Support In NICU 4 Nutrition Support is applied inappropriately in NICU1 1. A.S.P.E.N Nutrition Support Practice manual 2nd edition 2005 p301
- 5. Phases of NS in critically Ill Infants 5
- 6. Special Considerations in Premature & Sick Infants 6
- 7. Nutritional Issues In NICU 7
- 9. Peripheral Route of Nutrition 9
- 10. Peripheral Solutions – Osmolarity Calculations 10
- 11. Routes of Administration - Central 11
- 12. Central Access Options HICKMAN CATHETER PORT GROSHONG PICC LINE 12
- 14. Fluids 14
- 16. Phototherapy
- 17. RDS
- 18. Fever
- 19. Diuretics
- 20. GI losses
- 21. Glycosuria
- 22. Heat shields
- 23. Blankets
- 25. High humidity
- 26. Fluid overload
- 27. Heart failureIncreased Requirements Decreased Requirements
- 28. Fluids 16
- 29. Parenteral Nutrition 17 A.S.P.E.N. Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parenter Enteral Nutr. 2002;26(1suppl): 1SA–138SA.
- 31. OUTCOMES OF NUTRITION THERAPY 19
- 33. TPN Initiation…do not start at goal 21
- 34. Pathogenesis of Re-feeding Syndrome 22
- 35. Pathogenesis of Re-feeding Syndrome 23
- 39. Respiratory Insufficiency 27
- 40. Hematologic Effects of Hypophosphatemia 28
- 41. Hypokalemia 29
- 43. Recommendations to Avoid Re-feeding 31
- 45. 33
- 46. Parenteral nutrition Protein Requirements 34
- 49. Parenteral Nutrition Dextrose (3.4Kcalories per Gm) 37
- 54. essential fatty acid deficiency (EFAD) Deficiency of linoleic and linolenic acids Manifestations (hair loss, delay wound healing, dry scaly skin) EFAD can develop within 72 hours if exogenous fat is not given. EFAD can be prevented with as little as 0.5–1 g/kg/d of IV lipid 42
- 58. Calcium Phosphate Solubility Precipitation factor =mEq of Ca++ + mM of PO4 x 100 Vol (ml) of TPN before addition of Ca & Phosphate If AA Concentartion > 1.5% the precipitation factor must be < 3 If AA concentration >1 % and < 1.5%, the precipitation factor should be < 2 For PN solutions < 1% AA concentration, either calcium or phosphorous should be added Parenteral Nutrition 46
- 60. 48 Parenteral Nutrition 3. Effects of Early Erythropoietin Therapy on the Transfusion Requirements of Preterm Infants Below 1250 Grams Birth Weight A Multicenter, Randomized, Controlled Trial. Pediatrics. 2001;108:934–942.
- 61. Effects of micronutrient deficiency 49
- 62. Effects of micronutrient deficiency 50
- 63. Effects of micronutrient deficiency 51
- 65. Monitoring 53 Parenteral Nutrition
- 66. Monitoring 54 Parenteral Nutrition
- 73. Cyclic TPN 61
- 74. 62
- 76. Cause of Occlusion Thrombus Crystals Urokinase HCl 0.1N Success Failure Failure Success HCl Urokinase Success Success Failure Failure Ethanol 70% Ethanol 70% 64 Management Of Catheter Occlusion
- 77. Do’s and Don’tsParenteral Nutrition Solutions 65
- 78. 66 Do’s and Don’tsParenteral Nutrition Solutions
- 79. Filtration of Parenteral Nutrition Admixtures 67
- 80. Transitioning to Enteral Feeds 68
- 81. Enteral Nutrition Special Considerations in Neonates 69
- 84. Necrotizing Enterocolitis and Enteral Feeding 72
- 85. Necrotizing Enterocolitis and Enteral Feeding 73
- 90. Enteral Feeding Methods 78
- 91. Enteral Feeding Methods 79
- 100. Enteral Formulas 88
- 101. Thank you...
Notas del editor
- Diuretics case mineral and electrolyte losses.Corticosteroids used to shorten the ventilator support can cause negative nitrogen balance, delayed growth, glucose intolerance, bone demineralization and neurodevelopment impairment.