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Original Article
Critical Care Medicine
Timing of parenteral nutrition initiation in critically ill children: a randomized clinical trial
Nagwan Y. Saleh, Hesham M. Aboelghar, Nehad B. Abdelaty, Mohamed I. Garib, Asmaa A. Mahmoud
Clin Exp Pediatr. 2023;66(9):403-411.   Published online June 14, 2023
Question: What is the ideal initiation timing of parenteral nutrition for critically ill children?
Finding: This randomized clinical trial of 140 children examined the effects of an early or late start of parenteral nutrition on mechanical ventilation need (primary outcome) and length of stay and mortality (secondary outcomes).
Meaning: Children who received early versus late parenteral nutrition had lower mechanical ventilation need and duration.
Nutrition
The effect of high fat dietary modification and nutritional status on the outcome of critically ill ventilated children: single-center study
Nehal Mohamed El Koofy, Hanaa Ibrahim Rady, Shrouk Moataz Abdallah, Hafez Mahmoud Bazaraa, Walaa Ahmed Rabie, Ahmed Ali El-Ayadi
Clin Exp Pediatr. 2019;62(9):344-352.   Published online April 2, 2019
Background: Ventilator dependency constitutes a major problem in the intensive care setting. Malnutrition is considered a major determinant of extubation failure, however, attention has been attracted to modulating carbon dioxide production through decreasing carbohydrate loading and increasing the percent of fat in enteral feeds. The detected interrelation between substrate oxidation and ventilation outcome became the base of several research to...
Review Article
Neonatology (Perinatology)
Enteral nutrition for optimal growth in preterm infants
Myo-Jing Kim
Clin Exp Pediatr. 2016;59(12):466-470.   Published online December 31, 2016

Early, aggressive nutrition is an important contributing factor of long-term neurodevelopmental outcomes. To ensure optimal growth in premature infants, adequate protein intake and optimal protein/energy ratio should be emphasized rather than the overall energy intake. Minimal enteral nutrition should be initiated as soon as possible in the first days of life, and feeding advancement should be individualized according to the...

Original Article
Neonatology (Perinatology)
Modification of nutrition strategy for improvement of postnatal growth in very low birth weight infants
Ah Young Choi, Yong Wook Lee, Mea-young Chang
Clin Exp Pediatr. 2016;59(4):165-173.   Published online April 30, 2016
Purpose

To identify the effects of modified parenteral nutrition (PN) and enteral nutrition (EN) regimens on the growth of very low birth weight (VLBW) infants.

Methods

The study included VLBW infants weighing <1,500 g, admitted to Chungnam National University Hospital between October 2010 and April 2014, who were alive at the time of discharge. Subjects were divided according to 3 periods: period 1...

Case Report
Compartment syndrome due to extravasation of peripheral parenteral nutrition: extravasation injury of parenteral nutrition
Huee Jin Park, Kyung Hoon Kim, Hyuk Jin Lee, Eui Cheol Jeong, Kee Won Kim, Dong In Suh
Clin Exp Pediatr. 2015;58(11):454-458.   Published online November 22, 2015

Compartment syndrome is a rare but devastating condition that can result in permanent neuromuscular or soft tissue injuries. Extravasation injuries, among the iatrogenic causes of compartment syndrome, occur under a wide variety of circumstances in the inpatient setting. Total parenteral nutrition via a peripheral route is an effective alternative for the management of critically ill children who do not obtain...

Review Article
Nutritional strategy of early amino acid administration in very low birth weight infants
Byong Sop Lee
Clin Exp Pediatr. 2015;58(3):77-83.   Published online March 20, 2015

Relative to a fetus of the same gestational age, very low birth weight (VLBW) infants are more likely to be underfed and to undergo growth restriction during their early hospital stay. The current trend towards "early and aggressive" nutritional strategies in VLBW infants aims to overcome the early nutritional deficiency and thereby boost postnatal catch-up growth, simultaneously improving long-term neurodevelopmental...

Case Report
Wernicke's encephalopathy in a child with high dose thiamine therapy
So Won Park, Yoon Young Yi, Jung Woo Han, Heung Dong Kim, Joon Soo Lee, Hoon-Chul Kang
Clin Exp Pediatr. 2014;57(11):496-499.   Published online November 30, 2014

Wernicke's encephalopathy is an acute neurological disorder characterized by mental confusion, oculomotor dysfunction, and ataxia. It has been reported in individuals with alcohol dependence, hyperemesis gravidarum, and prolonged parenteral nutrition without vitamin supplementation. Here we present the case of a 13-year-old male patient with neuroblastoma and a history of poor oral intake and nausea for 3 months. After admission, he...

Original Article
Comparison of total parenteral nutrition-associated cholestasis according to amino acid mixtures in very low birth weight infants
Jin-Sung Choi, Yun-Jin Bae, Young Ah Lee
Clin Exp Pediatr. 2006;49(9):972-976.   Published online September 15, 2006
Purpose : The purpose of this study was to evaluate the effect of amino acid mixtures on incidence and severity of total parenteral nutrition associated-cholestasis(PNAC) in very low birth weight infants. Methods : Retrospective review of 63 very low birth weight infants(birth weight ≤1,500 g) who received total parenteral nutrition(TPN) in our neonatal intensive care unit from January 2000 to...
The diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants
Kyoung Soo Park, Myung Seok Shin, Mea Young Chang
Clin Exp Pediatr. 2006;49(8):851-856.   Published online August 15, 2006
Purpose : The purpose of this study is to find out the diagnostic significance of serum bile acid on total parenteral nutrition induced cholestasis in premature infants. Methods : Infants without cholestasis were classified into postnatal days and each change of serum bile acid was measured and analyzed. Also, the serum direct bilirubin, serum bile acid, γ-glutamic acid transferase, and alkaline...
Clinical Use and Complications of Percutaneous Central Venous Catheterization in Very Low Birth Weight Infants
Hyang Kim, Sun Hui Kim, Hyung Suck Byun, Young Youn Choi
Clin Exp Pediatr. 2005;48(9):953-959.   Published online September 15, 2005
Purpose : The administration of total parenteral nutrition(TPN) has become a standard procedure in the management of nutritionally deprived and critically low birth weight neonates. Sepsis remains the most frequent serious complication during TPN, resulting in increased morbidity, mortality and health care costs. This study was performed to evaluate the clinical efficacy and complications of percutaneous central venous catheterization(PCVC) in...
The Effect of Parenteral Nutrition and Respiratory Distress Syndrome in the Early Neonatal Period on Bone Mineralization at the Time of Reaching 2 kg Body Weight in Premature Infants
Yun-Jin Lee, Su-Eun Park, Jae-Hong Park
Clin Exp Pediatr. 2004;47(4):368-372.   Published online April 15, 2004
Purpose : To evaluate the effect of parenteral nutrition in early neonatal period on bone mineralization at the time of reaching 2 kg body weight in premature infants, bone mineral density(BMD) in infants who received long-term parenteral nutrition in the early neonatal period was measured and compared with infants who received enteral nutrition only. Methods : Twenty low birth weight infants(those...
Total Parenteral Nutrition-associated Cholestasis in Premature Infants
Kyung Pil Park, Se Young Kim, Heng Mi Kim
Clin Exp Pediatr. 2003;46(1):17-23.   Published online January 15, 2003
Purpose : Cholestasis is a major complication in prolonged use of TPN, especially in the neonatal period, but there are few long-term reviews examining the clinical course in premature infants. Thus, in this study, we reviewed premature infants with TPN-associated cholestasis(TPNAC) to determine the incidence, clinical courses and possible risk factors. Methods : Retrospective review of 66 premature infants less than...
Effect of Parenteral Nutrition Guideline Changes on Neonatal Sepsis in Premature Infants
Chang-Ryul Kim, Jae-Won Oh, Myung-Kul Yum, Soo-Jee Moon
Clin Exp Pediatr. 2001;44(6):620-626.   Published online June 15, 2001
Purpose : We hypothesized that decreased parenteral nutrition would lower the incidence of neonatal sepsis in premature infants. Methods : The study involves 223 premature infants who were admitted to the neonatal intensive care unit of Hanyang University Kuri Hospital from July 1995 to January 1999. Infants were divided into two groups based on different parenteral nutrition guidelines : Old...
Clinical Effects of Cyclic Parenteral Nutrition on Total Parenteral Nutrition Induced Cholestasis in Infants
Eun-Hee Chung, Kang Mo Ahn, Yun-Sil Chang, Won-Soon Park, Nam-Sun Beck, Jae-Hyun Lee
Clin Exp Pediatr. 1999;42(12):1689-1695.   Published online December 15, 1999
Purpose : This study was designed to assess the effects of cyclic parenteral nutrition(CP) on parenteral nutrition induced liver diseases. Methods : Before and after CP, data were collected on diagnosis, age, duration of parenteral nutrition, macronutrients and biochemical parameters. Initially parenteral nutrition was cycled off for 1-2 hours and the off-time was advanced by 0.5-1 hour daily over 1 week....
Case Report
A Case of Toxic Epidermal Necrolysis in Early Infancy
Min Seong Kim, Jeong Nyun Kim, Bang Soon Kim, Hong Joo Kim, Myung Jae Chey, Churl Young Chung
Clin Exp Pediatr. 1999;42(11):1594-1598.   Published online November 15, 1999
Toxic epidermal necrolysis(TEN) is a bullous disorder affecting mainly basal layers of epidermis by hypersensitive reaction. It is rarely reported in infants under six months of age. It can be developed by drug, infection, and vaccination, which makes it difficult to differentiate from staphylococcal scalded skin syndrome(SSSS) especially in early infancy. We report a case of TEN in a 6-week-old...
Original Article
Compatibility of Neonatal Parenteral Nutrient Solutions with Commonly Used Drugs during Y-site Delivery in NICU
Ju Hun Choi, Kyong Ju Jeong, Ha Ryung Cho, Dong Soo Yim, Seung Ki Choi, Kyu Hyung Lee
Clin Exp Pediatr. 1998;41(7):893-900.   Published online July 15, 1998
Purpose : Because vascular access sites in neonates are limited, intravenous(IV) medications must often be mixed with maintenance fluids, including parenteral nutrient(PN) solutions. This study was done to determine whether IV medications commonly prescribed in the neonatal in- tensive care unit(NICU) are compatible with the two neonatal PN solutions. Methods : The compatibility of neonatal PN solutions and selected other drugs...
Clinical Experiences with Total Nutrient Admixture in 26 Cases
Yong Soon Kwon, Eun Jin Choi, Soon Ok Byun, Ji Sub Oh, Hwan Seon Ryu, Charles D. Sands
Clin Exp Pediatr. 1992;35(7):921-932.   Published online July 15, 1992
Total Nutrient Admixture(TNA) is an intravenous nutrient system composed of dextrose, amino acid, fat, electrolytes, vitamins and trace elements in a single container which is administered over 24 hours. Twenty six seriously ill or premature neonatal patients reciving parenteral nutrition with TNA were studied by analyzing anthropometric parameters, laboratory values, and complications. The objective of the study was to test the...
Inciedence of Sepsis Associated with Total Parenteral Nutrition Solutions Made in the Nursery and Pharmacy
Moon Chan Kim, Jin Won Park, Yun Joo Chung
Clin Exp Pediatr. 1992;35(5):646-651.   Published online May 15, 1992
From 1985 to 1987, when Total Parenteral Nutrition (TPN) solutions was made in the nursery without laminar flow hood and other usual aseptic techniques (method 1), there was sepsis in 27% out of 33. From 1988 to 1990, to prevent high incidence of sepsis, TPN was made in the pharmacy under laminar flow hood and by pharmacist who wore scrub...
Sepsis Associated with Total Parenteral Nutrition in the Neonates.
Jae Won Huh, Jo Sam Koo, Yun Joo Cheung
Clin Exp Pediatr. 1989;32(4):495-499.   Published online April 30, 1989
The retrospective study was performed on the 33 neonates with TPN admitted to the nursery of Gospel Hospital of Kosin medical college between January 1985 and Jun 1987. 1) The incidence of sepsis during TPN was 27% and it was related only to the duration of TPN received for more than 7 days. 2) Major organisms were S. epidermids (30%), Enterobacter cloacae (20%). 3) Major...