1. Monitoring and management of hypertriglyceridemia in extremely low birth weight neonates receiving intravenous lipid emulsions: A national survey.
- Author
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Gabriel, Krystina, Hovater, Kylie, Gao, Hanzhi, de la Cruz, Diomel, Calkins, Kara L., and Neu, Josef
- Subjects
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VERY low birth weight , *INTRAVENOUS fat emulsions , *HYPERTRIGLYCERIDEMIA , *NEWBORN infants , *NURSE practitioners - Abstract
To assess the practice variation of defining, monitoring and managing hypertriglyceridemia (HTG) in extremely low birth weight neonates receiving intravenous lipid emulsions (IVLE). An 8-question survey created via the web survey site Qualtrics was distributed to neonatologists, neonatal nurse practitioners and fellows within the Section of Neonatal-Perinatal Medicine email directory list in the United States and Canada. Survey results were obtained between August and September 2022. There were 249 respondents from approximately 4000 members within the Section of Neonatal-Perinatal Medicine. Responses were documented as a frequency (percentage) with a margin of error of plus or minus 6.2 %. Most respondents were neonatologists, individuals practicing for >10 years and reported a unit-based policy for IVLE initiation and advancement. The definitions of HTG varied among respondents, with the majority (42.7 %) reporting a defining threshold of >200 mg/dL. Nineteen percent of respondents reported not routinely monitoring serum triglyceride concentrations with variable triglyceride monitoring intervals reported by other survey respondents. Regarding elevated triglyceride concentrations, 19.0 % reported decreasing the IVLE rate and checking triglyceride concentrations until normalization; 14.6 % reported IVLE discontinuation and monitoring triglyceride concentrations until normalization; 61.9 % reported using a combination of the above practices; and 4.4 % reported individualized practices for IVLE management with elevated triglyceride concentrations. This survey demonstrates a high variation in defining, monitoring and managing HTG in extremely low birth weight neonates and emphasizes the need for studies to better guide this practice. • Evidence supporting proposed definitions of neonatal hypertriglyceridemia is lacking. • Monitoring and managing neonatal hypertriglyceridemia is a highly variable practice. • Evidence based guidelines are needed for hypertriglyceridemia surveillance and management in order to ensure optimal nutrition. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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