title: Special Comments - Neonatal Intensive Care Drug Manual
text: |
  Neonatal Intensive Care Drug Manual
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  bet | 474/654 | Sana | 03.01.2022 | Hajmi | 1,5 Mb. | | #14803 |
  Special Comments
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  Evidence summary
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  Recommended daily intakes (RDI)
  Phosphorus absorption is typically 80% to 90% of dietary intake.3
  Parenteral intake: Previously, the recommended doses of parenteral Ca and P in preterm infants varied from 1.3–3 mmol Ca/kg/day and 1.0–2.3 mmol P/kg/day, with a Ca:P ratio in the range of 1.3–1.7.1,4-6 ESPGHAN 2018 updated guidelines on parenteral nutrition recommends the following Ca and Phosphate:12
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  Parenteral Ca
  mmol (mg)/kg/day
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  Parenteral Ph
  mmol (mg)/kg/day
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  Preterm during the first days of life
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  0.8-2.0 (32-80)
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  1.0-2.0 (31-62)
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  Growing preterm
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  1.6-3.5 (100-140)
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  1.6-3.5 (77-108)
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  Term neonate
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  0.8-1.5 (30-60)
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  0.7-1.3 (20-40)
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  Enteral intake: ESPGHAN 2010 Guidelines for enteral nutrition recommend 2–3 mmol/kg/day of a highly absorbable phosphate source in a ratio with calcium (Ca:P) of 1.5–2.0.7 American Academy of Pediatrics Committee on Nutrition 2013 Guidelines recommend Ca 150-200 mg/kg/day (3.8-5 mmol/kg/day) and P 75-140 mg/kg/day (2.4-4.5 mmol/kg/day) and 200-400 IU/day of vitamin D for enteral nutrition in preterm neonates.8
  The exact serum phosphorus concentration at which to commence supplementation of phosphate is not known and recommendations vary from 1.3 mmol/L8 to 1.8 mmol/L.9
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