All issues > Volume 44(6); 2001

Original Article

J Korean Pediatr Soc. 2001;44(6):620-626. Published online June 15, 2001.

Effect of Parenteral Nutrition Guideline Changes on Neonatal Sepsis in Premature Infants

Chang-Ryul CR Kim¹, Jae-Won JW Oh¹, Myung-Kul MK Yum¹, Soo-Jee SJ Moon¹

¹Department of Pediatrics, College of Medicine, Hanyang University, Seoul, Korea

Abstract

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 group(n=44, from July 1995 to June 1996) and New group(n=179, from July 1996 to January 1999). Parenteral nutrition in the Old group was given to infants with a birth weight of less than 1,800 g who needed NPO for more than 3 days, and those with a birth weight of more than 1,800 g who needed NPO for more than 5 days. In the New group, parenteral nutrition was given only to infants with surgical lesions, necrotizing enterocolitis or who needed NPO for more than 7 days.
Results
: Gestational age and birth weight are similar in both groups(33¡¾3 wks vs 33¡¾3 wk, 1,935¡¾604 g vs 1,823¡¾574 g). Parenteral nutrition is less frequently used in the New group compared to the Old group(8% vs 23%, P=0.007). Sepsis significantly decreased in the New group compared to the Old group(3% vs 23%, P=0.001). Breast milk, twin and use of antibiotics were more frequent in the New group compared to the Old group, but they did not affect the incidence of sepsis.
Conclusion
: The new guideline which restricts the use of parenteral nutrition decreased the incidence of sepsis to about 1/8 in premature infants. The findings suggest that the best way to reduce incidence of sepsis in premature infants may be to restrict parenteral nutrition.

Keywords :Neonatal sepsis, Parenteral nutrition, Prematurity