PD893 - OPTIMIZATION OF A STANDARDIZED PARENTERAL NUTRITION FORMULATION FOR POSTOPERATIVE CARDIAC NEONATES

PD893

OPTIMIZATION OF A STANDARDIZED PARENTERAL NUTRITION FORMULATION FOR POSTOPERATIVE CARDIAC NEONATES

T. Soares^1,*, C. Sampaio¹, S. Fraga¹, P. Meireles¹, P. Soares¹, H. Soares², P. Miragaia², R. Moita², S. Pissarra²

¹Pharmacy Compounding Department, ²Neonatal Intensive Care Unit, ULS S. João, Porto, Portugal

Rationale: Standardized parenteral nutrition (SPN) is essential to ensure safe and consistent nutritional support in postoperative cardiac neonates. Since 2018, a standardized parenteral nutrition formulation (SPNF) based on international recommendations has been used in this population in a tertiary center. Ongoing clinical monitoring revealed frequent potassium supplementation, suggesting the need to optimize electrolyte content. The aim of this work was to evaluate whether increasing potassium content in a SPNF, reduces the need for additional potassium supplementation.

Methods: A retrospective analysis of SPNF prescriptions was conducted in 83 patients. The pre optimization period included 61 neonates and 1,129 prescriptions, while the post optimization period included 22 neonates and 257 prescriptions. Potassium content was increased from 2.5 to 3.5 mEq/100 mL. The primary outcome was the proportion of prescriptions requiring additional potassium supplementation, compared using the chi-square test.

Results: With the initial formulation, potassium supplementation was frequent, indicating insufficient potassium delivery at the target volume of 80 mL/kg/day. After optimization, supplementation decreased significantly from 37.0% (418/1,129) to 24.9% (64/257), representing an absolute reduction of 12.1 percentage points and a relative reduction of 32.7% (p = 0.0002). In the post optimization period, most cases requiring supplementation occurred when target volume was not achieved due to clinical constraints.

Conclusion: Optimization of potassium content in a standardized parenteral nutrition formulation significantly reduced the need for supplementation in postoperative cardiac neonates. Continuous monitoring and adaptation of standardized formulations remain essential to address individual and population-level variability while preserving the benefits of standardization.

Disclosure of Interest: None declared