Aggressive parenteral nutrition remains the standard of care among very low-birth-weight preterm infants. However, recent studies only evaluate its impact on short-term outcomes. 

The present study compared the prevalence of hypercalcemia and hypophosphatemia among preterm infants receiving aggressive or standard parenteral nutrition. It compared a group of preterm infants weighing less than 1250 grams who received aggressive parenteral nutrition with a historical control group. The study estimated the prevalence of hypercalcemia and searched for its association with aggressive parenteral nutrition adjusting by confounders. It also estimated the mean phosphate level for the control group and compared it with the other group. 

The study observed-

• It included forty patients/group.
• Higher prevalence of hypercalcemia in the group receiving aggressive parenteral nutrition (87.5% versus 35%).
• Association of Aggressive parenteral nutrition with hypercalcemia after adjusting for birth weight, intrauterine growth restriction, amino acid, and calorie intake.
• The difference in the mean calcium level between both groups.
• More sepsis without reaching statistical significance in infants receiving aggressive parenteral nutrition and lower mean phosphate level than the control group.
• 90% prevalence of hypophosphatemia in this group.

These data depict an association between hypercalcemia/hypophosphatemia and aggressive parenteral nutrition. It is crucial to frequently monitor calcium and phosphate levels as they might be associated with adverse clinical outcomes.

Dik PHB, Galletti MF, Bacigalupo LT, et al. Hypercalcemia and hypophosphatemia among preterm infants receiving aggressive parenteral nutrition. Arch Argent Pediatr 2018;116(3):e371-e377