1 - Área da Mulher, Criança e Adolescência, NOVA Medical School | Faculdade de Ciências Médicas, Universidade Nova de Lisboa, Lisboa
2 - UCIN, Área da Mulher, Criança e Adolescente, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa
3 - Dietética e Nutrição, Escola Superior de Tecnologia da Saúde de Lisboa, Lisboa
- International Conference for Advancing Nutrition (iCAN). Lisboa, 02/02/2019 (Mesa redonda).
Very premature infants are at an increased risk for metabolic bone disease because they forego the last trimester of pregnancy, the period of greatest mineral accretion. Most of these infants cannot tolerate full enteral feedings within the first postnatal days or weeks, and energy and nutrients including protein, calcium, phosphorus, magnesium, and vitamin D need to be delivered by parenteral nutrition. The ongoing challenges for bone nutrition in preterm infants involve not only guaranteeing high concentrations of calcium and phosphorus in parenteral nutrition admixtures while maintaining their compatibility, but also achieving an optimal skeletal mineralization with the large amounts of minerals delivered. The main factors promoting calcium and phosphorus compatibility in parenteral nutrition admixtures include low final pH and temperature to produce more monobasic phosphate, use of organic calcium and P salts, and final high amino acid concentration with the inclusion of cysteine. These factors need to be considered in both parenteral nutrition compounding in hospital pharmacy and in ready to use commercial solutions.
Palavras Chave: bone health, calcium, parenteral nutrition, phosphorus, premature infants,