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Published online by Cambridge University Press: 05 August 2012
Early TPN should promote the overall nutritional health of the VLBW infant as evidenced by enhanced neurodevelopmental outcomes and growth at 18–22 months. In addition, males receiving early aggressive TPN showed improved head circumference growth at 18 months of age.
Early TPN affects growth by decreasing the magnitude of the nadir of postnatal weight loss and supporting an earlier return to birthweight. This early growth advantage contributes to less postnatal growth failure and extrauterine growth restriction.
Table 10.1 is the overall guide to providing TPN to VLBW infants. It is followed by Table 10.2, which assesses safety and tolerance to TPN with appropriate laboratory tests. Table 10.3 details the weaning TPN process as enteral nutrition is initiated and advanced, enabling the balance of fat, carbohydrates and protein.
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