The following is a summary of “Sodium Glycerophosphate Use in Parenteral Nutrition Improves Mineral Metabolism in Extremely Low Birth Weight Infants,” published in the FEBRUARY 2023 issue of Pediatrics by Hsu, et al.
For a study, researchers sought to evaluate the clinical effect of sodium glycerophosphate (NaGP) in parenteral nutrition solutions on mineral metabolism in extremely low birth weight (ELBW) infants.
The study included 95 ELBW infants treated with potassium phosphate (K3PO4) between January 2015 and December 2017 and 77 infants treated with NaGP between August 2018 and January 2021. Mineral intake over the first 14 days, changes in serum calcium, phosphorus, sodium, and alkaline phosphatase (ALP) levels over the first 1-3 months, and the rates of electrolyte imbalance and clinical morbidity were compared. In addition, high-risk infants with nil per os (NPO) status for >14 days and prolonged parenteral nutrition exposure were further analyzed as a subgroup.
NaGP was used in place of K3PO4 to greatly enhance Ca and P intake, but intakes were still below the recommended levels (Ca, 64-140 mg/kg/day; P, 50-108 mg/kg/day). The NaGP group’s serum Ca and P levels were noticeably higher after day 14, and their ALP levels were reduced after day 56 compared to the K3PO4 group’s values. In the subgroup analysis, the NaGP group had significantly decreased occurrences of bronchopulmonary dysplasia, hypophosphatemia, hyponatremia, and ALP > 500 IU/L.
Although the administration of NaGP instead of K3PO4 in parenteral nutrition regimens still did not provide adequate Ca and P intake for ELBW infants, higher intake significantly improved serum Ca and P levels, especially in ELBW infants with prolonged parenteral nutrition exposure. Using NaGP was associated with lower incidences of electrolyte imbalances and clinical morbidity in ELBW infants.