Total Parenteral Nutrition Practices in Canadian Neonatal and Pediatric Care Units: Results of a Survey
Bibliographic record
Abstract
ABSTRACT Objectives: To describe formulations and practices for total parenteral nutrition in the neonatal and pediatric units of Canadian hospitals. Methods: Hospitals with a neonatal or pediatric care unit (or both) were identified through the Guide to Canadian Health Care Facilities. Those where the working language was not English and those with fewer than 10 pediatric beds were excluded. A 72-item questionnaire was mailed to a designated health care professional at each hospital, and a reminder letter was sent 2 months later. Results: Thirty (71%) of the 42 eligible hospitals returned a total of 41 questionnaires, 25 for neonatal nutrition and 16 for pediatric nutrition. Approximately half of the hospitals had a printed handbook of guidelines for total parenteral nutrition. A variety of products were used in the hospitals. The choice at a given hospital usually depended on cost (for lipid solutions) and on recommendations in the scientific literature and previous experience (for amino acid solutions). Physicians, dietitians, and pharmacists were the primary professionals involved in total parenteral nutrition. A team approach was favoured by 31 (76%) of the 41 respondents, yet only 16 (39%) of the 41 units had such teams. All 16 respondents from pediatric units and 24 (96%) of the 25 respondents from neonatal units thought that standardization of practices and formulations across Canada was important. Conclusions: The finding that formulations and practices for total parenteral nutrition varied widely across Canadian hospitals and the opinions of respondents support the establishment of minimum national standards for total parenteral nutrition in neonates and children. RESUME Objectifs : Decrire les formules et les modalites de nutrition parenterale totale dans les unites de soins neonatals et pediatriques des hopitaux du Canada. Methodes : Les hopitaux dotes d’unites de soins neonatals ou pediatriques (ou des deux) ont ete identifies a partir du Guide des etablissements de sante du Canada. Les hopitaux dont la langue de travail n’etait pas l’anglais et ceux de moins de 10 lits pediatriques ont ete exclus. Un questionnaire de 72 questions a ete poste aux professionnels de la sante designes pour chaque hopital et une lettre de rappel leur a ete envoyee deux mois plus tard. Resultats : Des 42 hopitaux admissibles a participer a l’etude, 30 (71 %) ont retourne un total de 41 questionnaires ; 25 sur la nutrition neonatale et 16 sur la nutrition pediatrique. Environ la moitie des hopitaux possedaient des lignes directrices imprimees sur la nutrition parenterale totale et les hopitaux utilisaient une variete de produits. Le choix de ceux-ci depend habituellement du cout (pour les solutions de lipides) ainsi que des recommandations trouvees dans la documentation scientifique et l’experience (pour les solutions d’aminoacides). Les medecins, les dieteticiens et les pharmaciens etaient les principaux professionnels de la sante qui intervenaient en matiere de nutrition parenterale totale. Une approche multidisciplinaire etait favorisee par 31 (76 %) des 41 repondants, alors que seulement 16 (39 %) des 41 unites avaient une equipe multidisciplinaire a cette fin. Tous les 16 repondants des unites de soins pediatriques et 24 (96 %) des 25 repondants des unites de soins neonatals estimaient qu’il etait important de standardiser les formules et les modalites de nutrition parenterale totale au Canada. Conclusions : Les constatations a l’effet que les formules et les modalites de nutrition parenterale totale varient grandement dans les hopitaux du Canada et les opinions des repondants confirment le besoin de mettre sur pied des normes nationales minimales en matiere de nutrition parenterale totale chez les nouveau-nes et chez les enfants.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".