{
  "abstract": "Infancy is a critical period for growth and development, necessitating optimized nutrition to meet caloric requirements of 110–135 kcal/kg/day. Neonates unable to tolerate adequate enteral nutrition require total parenteral nutrition (TPN), which provides all nutrition intravenously, often alongside enteral feeds. Blood monitoring is essential for early detection of abnormalities, yet current practices vary significantly in terms of gestational age criteria for TPN, timing of initiation, frequency of biochemical monitoring, and management of derangements.This study presents a two-cycle audit conducted in a Level 3 neonatal intensive care unit, focusing on premature infants born at <32+6 weeks of gestation who received parenteral nutrition. Data collection for Cycle 1 occurred from September to November In 2022 and 2023, assessing monitoring frequency and biochemical derangements. Based on identified gaps, we introduced a guideline specifically addressing hypertriglyceridemia, accompanied by a pre-configured order set to standardize monitoring practices.Cycle 2 data were collected from January to March 2024 to evaluate the impact of these interventions.The second cycle demonstrated a median initiation time for monitoring improved from 21 hours to 12 hours, with an increase in TPN initiation for neonates under 24 hours of age. However, early monitoring was not sustained due to challenges such as the transition to new order communication systems and a lack of clinical engagement. A follow-up survey was conducted to investigate these barriers further.This audit highlights the necessity for continued education and systemic support to enhance biochemical monitoring and management practices for neonates on TPN, aiming to align with NICE/BAPM standards and ultimately improve patient outcomes.References Recommendations | Neonatal parenteral nutrition | Guidance | NICE The Provision of Parenteral Nutrition within Neonatal Services - A Framework for Practice (2016) | British Association of Perinatal Medicine Amal Akour, Lobna Gharaibeh, Omar El Khatib, Khawla Abu Hammour, Noor AlTaher, Salah AbuRuz, Muna Barakat. Treatment-related problems in neonates receiving parenteral nutrition: risk factors and implications for practice. 2024.",
  "authors": [
    {
      "affiliations": [
        "Medway Maritime Hospital"
      ],
      "name": "Abhishek Menon"
    }
  ],
  "title": "OC101 Improving biochemical monitoring and management of biochemical derangements in neonates on parenteral nutrition: a two-cycle audit at a tertiary neonatal unit in the United Kingdom",
  "uid": "68718492-855d-55fb-bdaf-0c475897117e"
}