Addamel

Nutrition support included enteral nutrition (EN) and parenteral nutrition (PN). Total parenteral nutrition (TPN) was provided during the first few days after ileostomy, jejunostomy, or anastomosis. The “all-in-one” solution contained lipids (Omegavan®, Fresenius Kabi or Lipofundin®, B. Braun Melsungen), amino acids (18AA-11; Treeful, Shanghai, China), a glucose solution, minerals, trace elements (Addamel; Fresenius Kabi, Wuxi, Jiangsu, China), water-soluble vitamins (Soluvit; Fresenius Kabi, Wuxi, Jiangsu, China), and fat-soluble vitamins (Vitalipid; Fresenius Kabi, Wuxi, Jiangsu, China) and was infused continuously via peripherally inserted central catheters (PICCs) or central venous catheters (CVCs) by infusion pumps (SN-1500H, Shenzhen, China). We replaced the medium chain triglyceride/long chain triglyceride (MCT/LCT)-based lipids with fish oil-based lipids (Omegavan; Fresenius Kabi, Jiangsu, China) when the levels of any three of the seven liver indicators were two times higher than normal. Enteral nutrition (breast milk, hydrolyzed formula, or amino acid-based formula) was introduced by pumping for 1–3 h through a nasal tube every 3 h, and advanced gradually based on intestinal tolerance. PN was decreased and weaned off when EN increased sufficiently to sustain adequate growth.

Parenteral nutrition: Individualized PN was prescribed daily. The PN solution containing amino acid (Pediatric Compound Amino Acid Injection 19AA-I, PAA 6%, Qidu, Shangdong, China), lipid (20% Medium and Long Chain Fat Emulsion Injection C6 ~ 24, Fresenius Kabi, Wuxi, Jiangsu, China), glucose, minerals, trace elements (Addamel; Fresenius Kabi, Wuxi, Jiangsu, China), water-soluble vitamins (Soluvit; Fresenius Kabi, Wuxi, Jiangsu, China) and fat-soluble vitamins (Vitalipid; Fresenius Kabi, Wuxi, Jiangsu, China) was started within the first 24 h of life and infused continuously for 24 h.
Enteral nutrition: Minimal enteral nutrition (MEN) was initiated as soon as possible after birth if applicable. A preterm formula (PreNan, Nestle, Germany) or mother’s own milk (MOM) was administrated through a nasogastric tube intermittently. Breastmilk energy estimates range from 65 to 70 kcal/dL [17 (link)]. We chose 67 kcal/dL to calculate the energy estimates.