Perioperative nutrition in extremely preterm infants undergoing surgery for patent ductus arteriosus

Background and aims Patent ductus arteriosus is a common neonatal morbidity affecting more than half of infants born extremely preterm. Suboptimal nutrition in extremely preterm infants in general has been demonstrated in recent studies. The aim of this study was to describe perioperative nutritional practices in Swedish neonatal intensive care units caring for extremely preterm infants undergoing surgery for patent ductus arteriosus. Methods Daily enteral and parenteral nutritional intakes during the perioperative week starting three days prior and ending three days after surgery were retrospectively evaluated in five University hospitals caring for infants born <27 weeks of gestation, between 2004 and 2007. Results In total, 132 infants and data from 912 perioperative days were included. Mean daily energy intakes during the perioperative week (range 78–105 kcal/kg/day) varied significantly between hospitals, with the lowest intakes on the day of surgery (range 54–87 kcal/kg/day). Mean daily protein intakes during the perioperative week did not vary (range 2.3–2.6 g/kg/day) but did differ on the day of surgery (range 1.5–2.4 g/kg/day). Median parenteral (range 33–99 mL/kg/day) and enteral (range 34–123 mL/kg/day) fluid intakes during the perioperative week, as well as median parenteral contents of energy and protein, varied significantly between hospitals. Conclusions Current recommended nutritional goals for extremely preterm infants were not met in the studied neonatal intensive care units. Suboptimal nutrition may have implications for short and long-term outcomes. Improved adherence to nutritional guidelines is warranted for these patients.