ABSTRACT
OBJECTIVE: To implement feeding guidelines to reduce advancement time and the incidence of parenteral nutrition-associated liver disease (PNALD) among intestinal surgical infants requiring parenteral nutrition (PN). STUDY DESIGN: Feeding guidelines with higher initial enteral nutrition (EN) volume and specific advancement criteria were implemented for surgical infants aged <6 months. Preimplementation and postimplementation outcomes were compared. RESULTS: There were 57 preimplementation and 33 postimplementation infants. The initial EN volume improved from 10 to 20 ml kg(-1) day(-1) (P<0.001). Time to reach 50% of goal calories from EN decreased by a median of 6 days (P=0.012) without a change in necrotizing enterocolitis incidence after resuming feeding. PNALD incidence decreased from 70% to 48% (P=0.046), and median peak direct bilirubin (DB) decreased from 5.6 to 2.3 mg dl(-1) (P=0.011). CONCLUSION: Feeding guideline implementation with higher initial feeding volume was well tolerated and resulted in faster achievement of 50% goal EN calories. PNALD incidence and peak DB were reduced.
Subject(s)
Digestive System Abnormalities/diagnosis , Digestive System Abnormalities/surgery , Enteral Nutrition/adverse effects , Enteral Nutrition/methods , Liver Diseases/prevention & control , Practice Guidelines as Topic , Academic Medical Centers , Female , Follow-Up Studies , Humans , Infant , Infant Care/methods , Infant Care/standards , Infant, Newborn , Infant, Premature , Intensive Care Units, Neonatal , Liver Diseases/etiology , Male , Nutrition Therapy/methods , Nutrition Therapy/standards , Nutritional Requirements , Postoperative Care/methods , Treatment Outcome , Weight Gain/physiologyABSTRACT
A method for the recovery of uranium from low-level liquid wastes is described. Uranium(VI) is reduced to uranium(IV) in sulphuric-phosphoric acid solution with iron(II). The uranium(IV) is precipitated as the double duoride with sodium. The uranium content of the filtrate is in the low ppm range. Possible modifications to the procedure are discussed.