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Nutrients
Volume 14
Issue 5
10.3390/nu14050919
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Review

Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes

by
Silvia Guiducci
1,
Miriam Duci
2,
Laura Moschino
1,
Marta Meneghelli
1,
Francesco Fascetti Leon
2,
Luca Bonadies
1,
Maria Elena Cavicchiolo
1 and
Giovanna Verlato
1,*
1
Neonatal Intensive Care Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy
2
Pediatric Surgery Unit, Department of Women’s and Children’s Health, University Hospital of Padova, 35128 Padova, Italy
*
Author to whom correspondence should be addressed.
Nutrients 2022, 14(5), 919; https://doi.org/10.3390/nu14050919
Submission received: 15 January 2022 / Revised: 16 February 2022 / Accepted: 17 February 2022 / Published: 22 February 2022
(This article belongs to the Special Issue Macronutrients and Micronutrients in Parenteral Nutrition)
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Abstract

Necrotizing enterocolitis (NEC) is the main gastrointestinal emergency of preterm infants for whom bowel rest and parenteral nutrition (PN) is essential. Despite the improvements in neonatal care, the incidence of NEC remains high (11% in preterm newborns with a birth weight <1500 g) and up to 20–50% of cases still require surgery. In this narrative review, we report how to optimize PN in severe NEC requiring surgery. PN should begin as soon as possible in the acute phase: close fluid monitoring is advocated to maintain volemia, however fluid overload and electrolytes abnormalities should be prevented. Macronutrients intake (protein, glucose, and lipids) should be adequately guaranteed and is essential in each phase of the disease. Composite lipid emulsion should be the first choice to reduce the risk of parenteral nutrition associated liver disease (PNALD). Vitamin and trace elements deficiency or overload are frequent in long-term PN, therefore careful monitoring should be planned starting from the recovery phase to adjust their parenteral intake. Neonatologists must be aware of the role of nutrition especially in patients requiring long-term PN to sustain growth, limiting possible adverse effects and long-term deficiencies.
Keywords: necrotizing enterocolitis; surgery; parenteral nutrition; macronutrients; micronutrients; parenteral nutrition associated liver disease necrotizing enterocolitis; surgery; parenteral nutrition; macronutrients; micronutrients; parenteral nutrition associated liver disease

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MDPI and ACS Style

Guiducci, S.; Duci, M.; Moschino, L.; Meneghelli, M.; Fascetti Leon, F.; Bonadies, L.; Cavicchiolo, M.E.; Verlato, G. Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes. Nutrients 2022, 14, 919. https://doi.org/10.3390/nu14050919

AMA Style

Guiducci S, Duci M, Moschino L, Meneghelli M, Fascetti Leon F, Bonadies L, Cavicchiolo ME, Verlato G. Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes. Nutrients. 2022; 14(5):919. https://doi.org/10.3390/nu14050919

Chicago/Turabian Style

Guiducci, Silvia, Miriam Duci, Laura Moschino, Marta Meneghelli, Francesco Fascetti Leon, Luca Bonadies, Maria Elena Cavicchiolo, and Giovanna Verlato. 2022. "Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes" Nutrients 14, no. 5: 919. https://doi.org/10.3390/nu14050919

APA Style

Guiducci, S., Duci, M., Moschino, L., Meneghelli, M., Fascetti Leon, F., Bonadies, L., Cavicchiolo, M. E., & Verlato, G. (2022). Providing the Best Parenteral Nutrition before and after Surgery for NEC: Macro and Micronutrients Intakes. Nutrients, 14(5), 919. https://doi.org/10.3390/nu14050919

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