{"id":1845,"date":"2026-10-27T09:33:29","date_gmt":"2026-10-27T14:33:29","guid":{"rendered":"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/?p=1845"},"modified":"2026-10-27T09:33:29","modified_gmt":"2026-10-27T14:33:29","slug":"nutricion-parenteral-neonatal-guias-recomendaciones","status":"publish","type":"post","link":"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/nutricion-parenteral-neonatal-guias-recomendaciones\/","title":{"rendered":"Nutrici\u00f3n parenteral neonatal"},"content":{"rendered":"<p>Las tres gu\u00edas internacionales vigentes en nutrici\u00f3n parenteral neonatal (NPT neonatal) a la fecha son <strong>ASPEN (2023) <\/strong><a class=\"bibliography-sup\" title=\"1.\tRobinson DT, Calkins KL, Chen Y, Cober MP, Falciglia GH, Church DD, Mey J, McKeever L, Sentongo T. Guidelines for parenteral nutrition in preterm infants: The American Society for Parenteral and Enteral Nutrition. JPEN J Parenter Enteral Nutr. 2023 Sep;47(7):830-858. doi: 10.1002\/jpen.2550. Epub 2023 Aug 23. Erratum in: JPEN J Parenter Enteral Nutr. 2024 Feb;48(2):242-244. doi: 10.1002\/jpen.2582. PMID: 37610837.\" href=\"#\" data-bibliography-link=\"\">(1)<\/a>, <strong>NICE (2020)<\/strong> <a class=\"bibliography-sup\" title=\"2.\tNeonatal parenteral nutrition. London: National Institute for Health and Care Excellence (NICE); 2020 Feb 26. PMID: 32282154.\" href=\"#\" data-bibliography-link=\"\">(2)<\/a>\u00a0y <strong>ESPGHAN\/ESPEN\/ESPR\/CSPEN (2018) <\/strong><a class=\"bibliography-sup\" title=\"3.\tJoosten K, Embleton N, Yan W, Senterre T; ESPGHAN\/ESPEN\/ESPR\/CSPEN working group on pediatric parenteral nutrition. ESPGHAN\/ESPEN\/ESPR\/CSPEN guidelines on pediatric parenteral nutrition: Energy. Clin Nutr. 2018 Dec;37(6 Pt B):2309-2314. doi: 10.1016\/j.clnu.2018.06.944. Epub 2018 Jun 18. PMID: 30078715.\" href=\"#\" data-bibliography-link=\"\">(3)<\/a>; integran evidencia contempor\u00e1nea, como ensayos cl\u00ednicos, revisiones Cochrane, metaan\u00e1lisis, para ofrecer una s\u00edntesis cl\u00ednicamente utilizable.<\/p>\n<p>Ninguna gu\u00eda es superior por s\u00ed sola; la pr\u00e1ctica \u00f3ptima combina la claridad operativa de NICE, el marco fisiol\u00f3gico y por subgrupos de ESPGHAN, y la disciplina de evidencia de ASPEN <a class=\"bibliography-sup\" title=\"4.\tBhatt AH. Neonatal parenteral nutrition: An expert narrative review of international guidelines and contemporary evidence. J Neonatal Perinatal Med. 2026 Jul 10:19345798261468683. doi: 10.1177\/19345798261468683. Epub ahead of print. PMID: 42430646.\" href=\"#\" data-bibliography-link=\"\">(4)<\/a>.<\/p>\n<p>La cantidad de grasa, prote\u00edna y energ\u00eda administrada en la primera semana de vida tiene efectos a largo plazo en crecimiento y neurodesarrollo. No es solo un puente hasta la v\u00eda enteral. Sin embargo, persisten vac\u00edos importantes de evidencia: composici\u00f3n ideal de amino\u00e1cidos y l\u00edpidos, dosis \u00f3ptima en subpoblaciones (retraso del crecimiento intrauterino, encefalopat\u00eda hip\u00f3xico-isqu\u00e9mica, cardiopat\u00edas, hernia diafragm\u00e1tica), y variabilidad significativa entre Unidad de Cuidados Intensivos Neonatales <a class=\"bibliography-sup\" title=\"5.\tStrobel KM, Martin CR. Current approaches to parenteral nutrition in preterm infants. Semin Perinatol. 2026 Jun;50(4):152237. doi: 10.1016\/j.semperi.2026.152237. Epub 2026 Apr 26. PMID: 42045058.\" href=\"#\" data-bibliography-link=\"\">(5)<\/a>.<\/p>\n<p><strong>Puntos clave en la nutrici\u00f3n parenteral neonatal<\/strong><\/p>\n<ul>\n<li>Iniciar NPT sin demora cuando la v\u00eda enteral es claramente insuficiente<\/li>\n<li>Amino\u00e1cidos y l\u00edpidos tempranos, sin retraso innecesario<\/li>\n<li>Glucosa titulada seg\u00fan tolerancia individual, no por f\u00f3rmula fija<\/li>\n<li>Vitaminas y oligoelementos desde el inicio<\/li>\n<li>Vigilancia estrecha de alteraciones electrol\u00edticas y complicaciones hep\u00e1ticas o de cat\u00e9ter <a class=\"bibliography-sup\" title=\"4.\tBhatt AH. Neonatal parenteral nutrition: An expert narrative review of international guidelines and contemporary evidence. J Neonatal Perinatal Med. 2026 Jul 10:19345798261468683. doi: 10.1177\/19345798261468683. Epub ahead of print. PMID: 42430646.\" href=\"#\" data-bibliography-link=\"\">(4)<\/a>.<\/li>\n<\/ul>\n<h3>Aportes de las gu\u00edas actuales sobre nutrici\u00f3n parenteral neonatal<\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"wp-image-1846 aligncenter\" src=\"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-300x198.png\" alt=\"Nutricion neonatal\" width=\"671\" height=\"443\" srcset=\"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-300x198.png 300w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-1024x675.png 1024w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-768x506.png 768w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-1536x1013.png 1536w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-2048x1350.png 2048w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-1-569x375.png 569w\" sizes=\"auto, (max-width: 671px) 100vw, 671px\" \/><\/p>\n<p>&nbsp;<\/p>\n<ul>\n<li><strong>Punto clave:<\/strong> aumentar amino\u00e1cidos y l\u00edpidos \u2014no solo reducir glucosa\u2014 disminuye episodios de hiperglucemia (balance de macronutrientes, no solo la glucosa aislada)<\/li>\n<li><strong>Insulina de rutina: NO recomendada<\/strong><\/li>\n<li>Los prematuros no sintetizan end\u00f3genamente varios amino\u00e1cidos (ciste\u00edna, tirosina, glicina, arginina, prolina, asparagina, glutamina)<\/li>\n<li>Taurina: mejora absorci\u00f3n de grasa<\/li>\n<li>Iniciar l\u00edpidos el primer d\u00eda de vida es seguro y recomendado: 1\u20131.5 g\/kg\/d\u00eda, avanzar 0.5\u20131 g\/kg\/d\u00eda hasta 3 g\/kg\/d\u00eda de mantenimiento<\/li>\n<li>Infusi\u00f3n continua en 24 h, con protecci\u00f3n de la luz (evita peroxidaci\u00f3n de los l\u00edpidos) <a class=\"bibliography-sup\" title=\"5.\tStrobel KM, Martin CR. Current approaches to parenteral nutrition in preterm infants. Semin Perinatol. 2026 Jun;50(4):152237. doi: 10.1016\/j.semperi.2026.152237. Epub 2026 Apr 26. PMID: 42045058.\" href=\"#\" data-bibliography-link=\"\">(5)<\/a>.<\/li>\n<\/ul>\n<h3>Controversias cl\u00ednicas<\/h3>\n<ol>\n<li><strong>Dosis m\u00e1xima de amino\u00e1cidos<\/strong>: dosis m\u00e1s altas <strong>no<\/strong> mejoran neurodesarrollo ni crecimiento. Mensaje clave: &#8220;m\u00e1s no es mejor&#8221;.<\/li>\n<li><strong>Neonato a t\u00e9rmino cr\u00edticamente enfermo<\/strong>: NPT tard\u00eda (d\u00eda 8) redujo infecciones y aceler\u00f3 el alta de UCIP, con m\u00e1s hipoglucemia. Aqu\u00ed s\u00ed hay desacuerdo real entre NICE (proactiva) y Europa (cautelosa).<\/li>\n<li><strong>NPT estandarizada vs. individualizada<\/strong> \u2014 NICE la recomienda de rutina; ASPEN es reservada<\/li>\n<li><strong>Interpretaci\u00f3n de triglic\u00e9ridos<\/strong> \u2014 no hay umbral universal; un valor elevado no debe llevar autom\u00e1ticamente a suspender l\u00edpidos.<\/li>\n<li><strong>Emulsiones lip\u00eddicas mixtas \/ con aceite de pescado<\/strong>: SMOFlipid y Omegaven reducen colestasis <a class=\"bibliography-sup\" title=\"4.\tBhatt AH. Neonatal parenteral nutrition: An expert narrative review of international guidelines and contemporary evidence. J Neonatal Perinatal Med. 2026 Jul 10:19345798261468683. doi: 10.1177\/19345798261468683. Epub ahead of print. PMID: 42430646.\" href=\"#\" data-bibliography-link=\"\">(4)<\/a>.<\/li>\n<\/ol>\n<h3>Nutrici\u00f3n parenteral en situaciones cl\u00ednicas neonatales especiales<\/h3>\n<ul>\n<li><strong>Neonato a t\u00e9rmino cr\u00edticamente enfermo:<\/strong> individualizar, no protocolizar<\/li>\n<li><strong>Prematuro extremo:<\/strong> vigilar f\u00f3sforo\/potasio\/magnesio al escalar amino\u00e1cidos; avance cauteloso de glucosa<\/li>\n<li><strong>NPT prolongada (&gt;2 semanas) \/ falla intestinal:<\/strong> priorizar prevenci\u00f3n de colestasis, considerar emulsiones con aceite de pescado<\/li>\n<li><strong>Escalamiento agresivo de macronutrientes:<\/strong> siempre debe acompa\u00f1arse de vigilancia bioqu\u00edmica igualmente agresiva (riesgo de s\u00edndrome tipo realimentaci\u00f3n) <a class=\"bibliography-sup\" title=\"4.\tBhatt AH. Neonatal parenteral nutrition: An expert narrative review of international guidelines and contemporary evidence. J Neonatal Perinatal Med. 2026 Jul 10:19345798261468683. doi: 10.1177\/19345798261468683. Epub ahead of print. PMID: 42430646.\" href=\"#\" data-bibliography-link=\"\">(4)<\/a>.<\/li>\n<\/ul>\n<h3>Poblaciones especiales y actuales recomendaciones.\u00a0 <strong><a class=\"bibliography-sup\" title=\"5.\tStrobel KM, Martin CR. Current approaches to parenteral nutrition in preterm infants. Semin Perinatol. 2026 Jun;50(4):152237. doi: 10.1016\/j.semperi.2026.152237. Epub 2026 Apr 26. PMID: 42045058.\" href=\"#\" data-bibliography-link=\"\">(5)<\/a><\/strong><\/h3>\n<p><img loading=\"lazy\" decoding=\"async\" class=\" wp-image-1848 aligncenter\" src=\"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-2-1-283x300.png\" alt=\"Nutricion parenteral neonatal\" width=\"551\" height=\"584\" srcset=\"https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-2-1-283x300.png 283w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-2-1-965x1024.png 965w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-2-1-768x815.png 768w, https:\/\/lam.unitedforclinicalnutrition.com\/es-co\/wp-content\/uploads\/sites\/7\/2026\/10\/nutricion-parenteral-neonatal-2-1-1447x1536.png 1447w\" sizes=\"auto, (max-width: 551px) 100vw, 551px\" \/><\/p>\n<h3>Conclusiones sobre la nutrici\u00f3n parenteral neonatal<\/h3>\n<p>La NPT neonatal debe verse como un puente hacia desenlaces significativos: crecimiento, per\u00edmetro cef\u00e1lico, salud hep\u00e1tica, neurodesarrollo y no solo como una prescripci\u00f3n bioqu\u00edmica.<\/p>\n<p>La administraci\u00f3n de nutrientes en los primeros d\u00edas de vida no solo afecta el crecimiento, sino tambi\u00e9n el desarrollo org\u00e1nico, la funci\u00f3n y la programaci\u00f3n metab\u00f3lica que influyen en los desenlaces de salud a largo plazo.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Las tres gu\u00edas internacionales vigentes en nutrici\u00f3n parenteral neonatal (NPT neonatal) a la fecha son ASPEN (2023) (1), NICE (2020) (2)\u00a0y ESPGHAN\/ESPEN\/ESPR\/CSPEN (2018) (3); integran evidencia contempor\u00e1nea, como ensayos cl\u00ednicos, revisiones Cochrane, metaan\u00e1lisis, para ofrecer una s\u00edntesis cl\u00ednicamente utilizable. Ninguna gu\u00eda es superior por s\u00ed sola; la pr\u00e1ctica \u00f3ptima combina la claridad operativa de NICE, [&hellip;]<\/p>\n","protected":false},"author":5728,"featured_media":1849,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":"","_members_access_role":[],"_members_access_error":""},"categories":[8,1],"tags":[],"class_list":["post-1845","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-nutricion-parenteral","category-sin-categorizar"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v28.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Nutrici\u00f3n parenteral neonatal: gu\u00edas y recomendaciones<\/title>\n<meta name=\"description\" content=\"Conoce las principales gu\u00edas y recomendaciones sobre nutrici\u00f3n parenteral neonatal, sus aportes, controversias y aplicaciones cl\u00ednicas.\" 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