Abstract:

At present, over 1million critically ill newborn infants (including premature neonates, low birth weight babies and those with congenital malformation) each year need medical therapy shortly after birth, and most of them need nutrition support which is not only an essential part of the whole treatment but also important for their later health. Our research group carried out a series of basic and clinical research focusing on nutrition support in critically ill neonate ever since 1985. We found that the energy expenditure in neonates was lower than formula predicted value, and changed the energy recommendation to the value of 60-80 kcal/(kg·d) for parenteral nutrition. We also successfully developed the first domestic pediatric amino acid preparation based on the analysis of serum amino acid characteristics in Chinese neonates. We help to introduce new techniques for nutrition support in neonates, including jejunal puncture ostomy and percutaneous endoscopic gastrostomy for enteral nutrition, as well as the use of peripherally inserted central venous catheters for parenteral nutrition. Liver injury is a severe complication of parenteral nutrition, and our studies revealed that oxidative stress related mitochondrial apoptotic pathway might be an important mechanism, while glutamine showed protective effect not only in animal study but also in our clinical trial. In addition, we successful implemented intestinal rehabilitation therapy in 46 neonates with short bowel syndrome from all around the country, including one case with residual small intestine of only 25 cm.In the year 2005 and 2010, we formulated evidence-based Chinese guidelines of clinical nutrition support in neonates and pediatric patients, which help to improve the application of adequate nutrition support in the field of neonatology and pediatrics. The research achievement won the second prize of National Science and Technology Progress Award.

Key words: neonate, nutrition support, energy expenditure, parenteral nutrition associated liver injury, short bowel syndrome