2.Comparison Between Sodium Acetate and Sodium Chloride in Parenteral Nutrition for Very Preterm Infants on the Acid-Base Status and Neonatal Outcomes
Adli ALI ; Ee-Yan ONG ; Birinder Kaur Sadu SINGH ; Fook-Choe CHEAH
Pediatric Gastroenterology, Hepatology & Nutrition 2020;23(4):377-387
Purpose:
To compare between sodium acetate (SA) and sodium chloride (SC) in parenteral nutrition (PN) with associated metabolic acidosis and neonatal morbidities in preterm infants.
Methods:
Preterm infants below 33 weeks gestational age, and with a birth weight under 1,301 g were enrolled and further stratified into two groups: i) <1,000 g, or ii) ≥1,000 g in birth weight. The subjects were randomized to receive PN containing SA or SC within the first day of life. The results of routine blood investigations for the first 6 days of PN were collated, and the neonatal outcomes were recorded upon discharge or demise.
Results:
Fifty-two infants entered the study, with 26 in each group: 29 infants had extremely low birth weight (ELBW). There were no significant differences in birth weight, gestation, sex, exposure to chorioamnionitis and antenatal steroids, surfactant doses and duration of mechanical ventilation between groups. The SA group had significantly higher mean pH and base excess (BE) from days 4 to 6 than the SC (mean pH, 7.36 vs. 7.34; mean BE −1.6 vs. −3.5 [p<0.01]), with a two-fold increase in the mean BE among ELBW infants. Significantly fewer on SA required additional bicarbonate (n=4 vs. 13, p=0.01). The rate of bronchopulmonary dysplasia (BPD) was approximately four-fold lower in SA than SC (n=3 vs. 11, p<0.01). No significant differences were observed in necrotizing enterocolitis, patent ductus arteriosus, retinopathy of prematurity, cholestatic jaundice, and mortality between groups.
Conclusion
The use of SA in PN was associated with reduced metabolic acidosis and fewer BPD.
3.Prevalence and Management of Functional Gastrointestinal Disorders in Infants: An Asian Perspective
Wei CAI ; Lalit BHARADIA ; Mohammad JUFFRIE ; Fook Choe CHEAH ; Seng Hock QUAK ; Vitaya TITAPANT ; Ruurd VAN ELBURG ; Thomas LUDWIG
Pediatric Gastroenterology, Hepatology & Nutrition 2018;21(1):76-77
No abstract available.
Asian Continental Ancestry Group
;
Gastrointestinal Diseases
;
Humans
;
Infant
;
Prevalence
4.Recommendations to promote breast milk feeding and enhance nutritional care for preterm infants in the Asia-Pacific region: highlights from a roundtable discussion of key opinion leaders
Fook-Choe Cheah ; Tian-Lee Tan ; Ursula Herulah ; Charisma Dilantika ; Leilani Muhardi ; Girish Deshpande ; Rinawati Rohsiswatmo ; Satish Saluja ; Ruurd Van Elburg
Malaysian Journal of Nutrition 2021;27(No.2):201-207
Introduction: Preterm infants are vulnerable to nutritional deficiencies, thus
optimal nutrition is crucial in promoting growth among these infants. However,
socio-cultural complexities and limited resources in the Asia-Pacific demands
a judicious approach in implementing nutritional care that is pragmatic to align
with current evidence-based recommendations. Methods: A roundtable meeting
was held in Jakarta in 2017 for key opinion leaders in neonatology from the Asia-
Pacific to discuss issues when delivering nutritional care in this region and the
unique circumstances encountered. Results: Priority areas discussed include: (i)
breast milk feeding, (ii) donor milk bank/sharing, (iii) human milk fortification, and
(iv) nutrient-enriched breast milk substitutes. Socio-cultural practices impeding
breastfeeding, insufficient maternity leave, the religious issue of milk kinship, and
limited availability of specialty nutritional care products were among the most
challenging factors. Conclusion: The group proposed recommendations to enhance
breastfeeding uptake, accessibility to a complete portfolio of specialty nutritional
care products, and encouraging more active collaborations to engage policy makers
in addressing these contemporary issues.