Calcium and Phosphorus Intake by Parenteral Nutrition in Preterm Infants

Abstract

AbstractVery premature infants are at an increased risk for metabolic bone disease because they forego thelast trimester of pregnancy, the period of greatest mineral accretion. Most of these infants cannottolerate full enteral feedings within the first postnatal days or weeks, and nutrients including calciumand phosphorus need to be delivered by parenteral nutrition. The ongoing challenges for bonenutrition in preterm infants involve not only guaranteeing high concentrations of calcium andphosphorus in parenteral nutrition admixtures while maintaining their compatibility but also achievingan optimal skeletal mineralization with the large amounts of minerals delivered. The main factorspromoting calcium and phosphorus compatibility in parenteral nutrition admixtures include lowfinal 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.