Yenidoğan Bebekte Parenteral Beslenme ve Tedavi Prensipleri

ÖzPrematüre bebeklerde parenteral beslenme mümkün olan en kısa zamanda terci-hen ilk 24 saat içinde başlanmalıdır. Parenteral beslenme ile doğumdan sonra büyüme ve nörolojik gelişimin yakalanması amaçlanmaktadır. İlk gün yüksek aminoasit alımı iyi tolere edilir ve negatif nitrojen dengesinden korur. İntravenöz yağ emülsiyonları yüksek dansitelerinden dolayı iyi enerji kaynaklarıdır. Aynı zamanda santral sinir sistemi ve retinanın gelişimi  için gerekli olan esansiyel yağ asitlerini (EYA) içeririler. Prematüre bebeklerde glukoz metabolizmasına bağlı bozukluklar görülebilir. Hiperglisemi ve hipoglisemiye yatkınlık gösterirler. Doğumdan sonra geçiş periyodunda su ve elektrolit dengesi yakından izlenmelidir. Parenteral beslenme sıvıları kompleks içerikli sıvılardır. Uygulayıcıların yan etkiler, sıvıların içerikleri ve uygulama yolları (periferik ve santral yol) açısından eğitimli olmaları gerekmektedir.

Principles of Parenteral Nutrition in Neonates

AbstractParenteral nutrition (PN) in preterm infants should be initiated as soon as posssible, preferably within the first 24 hours in order to prevent postnatal growth failure and improve  neuro development outcome. Providing high levels of parenteralamino acids from the first day of life prevents negative nitrogen balance and welltolerated. Intravenous lipid emulsions (ILE) constitute a good energy source because of their high energy density. ILE provide essential fatty acids (EFA) along  their long-chain polyunsatured fatty acid (LC-PUFA) derivates are necessary for cen-tral nervous system development and retinal growth. In preterm infants glucose homeostasis is stil immature and abnormalities of glucose homeostasis are common.Prematüre infants prone to hyperglycemia as well as hypoglycemia. Postpartum there is a transition period when the water and electrolyte balance may be severely disturbed and should be closed monitored. PN is complex prescription therapy associated with significant adverse effects. The prescriber should be well versed in appropriate indications for PN as well as access devices (peripheral and central) and theirassociated complications.

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