The aim of our work is to study the effect of total parenteral nutrition (TPN) cycling in
preterm infants on hypercalcuria (excessive calcium excretion in urine). TPN cycling refers
to administering the TPN over a portion of the day rather than the whole day. Our
hypothesis is that cyclic TPN includes more hypercalcuria in preterm infants as compared to
Measure Urinary Calcium(Ca) during the periods of continuous and cyclic TPN.
Compare the amount of Ca losses in the urine continuous vs. cyclic TPN
Randomized cross over design, in which babies will receive TPN either continuously or on a
cyclic basis for 3 days. The patients will then be crossed over to receive the other way of
administration over the following 3 days, thus each patient will serve as his or her own
control. Continuous TPN will be administered over 24 hours for 3 days, while the cyclic TPN
will be given for 18 hours then followed by a Dextrose only solution at the same
concentration and rate as the TPN for 6 hours. Trophic feeds up to 20 ml/kg/day will be
allowed throughout the study period at the discretion of the attending neonatologist.
- Preterm babies with birth weights of 1500 gm or less.
- Expected to be restricted from oral feeding or on trophic feeds
- On TPN for at least 6 days
- Infants who at the time of enrollment are on any diuretics (Lasix,
hydrochlorothiazide, Aldactone, etc.) or caffeine
- those who are hemodynamically unstable
- Or have renal or hepatic insufficiency
- Infants with major congenital anomalies