Newborn parenteral nutrition evaluation method and system with heat card as guidance

Abstract

The invention relates to the technical field of newborn clinical nutriology, and discloses a newborn parenteral nutrition evaluation method and system oriented by calorie, and the method comprises the steps: building a multi-dimensional energy level model, combining with enteral nutrition absorption rate difference correction, and precisely calculating a parenteral nutrition calorie target value by using a core balance formula 1 = EN / A + PN / B, and the composition proportion of glucose, amino acid and fat emulsion is dynamically adjusted in an optimized osmotic pressure safety range. The method provided by the invention effectively solves the clinical problems of extensive heat card supply, high liquid overload risk, insufficient osmotic pressure utilization, easy unbalance of nutritional structure and the like in the traditional method, remarkably promotes ideal growth of fat-free weight of the premature infant, and reduces the incidence rate of venous nutrition related complications.

Description

Technical Field

[0001] This invention relates to the field of neonatal clinical nutrition technology, and in particular to a calorie-based method and system for assessing neonatal parenteral nutrition. Background Technology

[0002] The nutritional status of newborns, especially premature infants, is directly related to their survival rate, incidence of complications, and long-term neurological and physical development. Parenteral nutrition is an indispensable support method in early life, especially before enteral nutrition is fully established. However, traditional methods for calculating parenteral nutrition have significant shortcomings.

[0003] The currently prevalent clinical approach can be summarized as a fluid-volume-oriented model. The typical process is as follows: First, determine the child's total 24-hour fluid intake (ml / kg·d); second, within this total fluid volume framework, allocate the dosage of electrolytes (sodium, potassium, etc.); next, refer to the previous day's values ​​or empirical values ​​to set the dosage of amino acids and fat emulsions; finally, replenish the remaining fluid volume with glucose solution, thus passively determining the total calories. This method has four major drawbacks: 1) Calorie supply is coarse and uncontrollable, often disconnected from the child's actual needs; 2) The pursuit of high calories can easily lead to fluid overdose, potentially causing edema, delayed PDA shut-off, and heart failure; 3) Excessive conservatism due to concerns about excessive osmotic pressure can restrict nutrient concentrations, failing to provide sufficient calories when fluid restriction is necessary; 4) The nutritional structure (calorie-to-nitrogen ratio) is easily imbalanced, leading to abnormal fat accumulation rather than ideal weight gain.

[0004] While existing clinical guidelines (such as the "Clinical Application Guidelines for Neonatal Nutritional Support in China") provide recommended ranges for energy and nutrients under different circumstances, there is a lack of a systematic operational plan that uses energy requirements as the starting point for proactive regulation, integrates differences in enteral nutrition, safe utilization of osmolarity, and dynamic feedback adjustments. Clinicians often rely on personal experience for estimation and adjustment, leading to inconsistencies and potential risks in practice.

[0005] Therefore, there is an urgent need in this field for a parenteral nutrition assessment method that is conceptually innovative, logically clear, highly operable, and can integrate the advantages of existing data tools, in order to solve the aforementioned long-standing problems. Summary of the Invention

[0006] In order to overcome the shortcomings of the prior art, the present invention aims to provide a calorie-oriented neonatal parenteral nutrition assessment method and system, which aims to solve the problems of energy supply being out of sync with individual needs, high risk of fluid overload, insufficient nutrition supply under strict fluid restriction conditions, and nutritional imbalance caused by the traditional neonatal parenteral nutrition support paradigm that uses fluid volume as the starting point for calculation.

[0007] The first aspect of this invention provides a calorie-oriented method for assessing neonatal parenteral nutrition, comprising the steps of: S1: acquiring individual information of the newborn, including gestational age, birth weight, age in days, and disease status; S2: based on the individual information, determining an initial energy level from a set of preset energy levels, wherein the energy level is determined by a pair of parameters (A, B) Definition, where A represents the target calorie value for total enteral nutrition and B represents the target calorie value for total parenteral nutrition; S3: Obtain the actual intake data of current enteral nutrition and calculate the corrected effective enteral nutrition calorie value EN based on the intestinal absorption rate of different nutrients; S4: Substitute the effective enteral nutrition calorie value EN and the parameters A and B of the selected energy level into the core energy balance formula: 1 = EN / A + PN / B to calculate the current target calorie value PN for parenteral nutrition; S5: Using the target calorie value PN for parenteral nutrition as a constraint, allocate and calculate the dosage of glucose, amino acids and fat emulsion within the preset osmotic pressure safety limit, wherein the osmotic pressure safety limit is set differently depending on whether the infusion route is peripheral vein or central vein; S6: Execute the nutritional support plan calculated based on step S5 and periodically monitor the growth and metabolic indicators of the newborn; S7: Based on the monitoring results, dynamically evaluate the suitability of the initial energy level, and dynamically adjust to a new energy level based on the evaluation results, returning to step S4 for iterative calculation.

[0008] Optionally, in a first implementation of the first aspect of the present invention, the preset multiple energy levels in step S2 include, but are not limited to, five levels: (A=110, B=80), (A=120, B=90), (A=130, B=100), (A=140, B=110), (A=150, B=120), with units of kcal / kg·d; the selection criteria for energy levels include: the smaller the gestational age, the lower the weight, and the presence of hypermetabolic diseases, the higher the A and B values ​​tend to be selected.

[0009] Optionally, in the second implementation of the first aspect of the present invention, in step S3, the set value of the intestinal absorption rate is: glucose 100%, amino acids 80%-85%, fat emulsion 50%-90%; when calculating the effective enteral nutrition calorie value EN, it is necessary to obtain the calorie and nutrient content per unit volume from the commonly used milk powder nutrient composition area according to the type of milk ingested, and apply the absorption rate for conversion.

[0010] Optionally, in the third implementation of the first aspect of the present invention, in step S5, the preset osmotic pressure safety limit is: ≤900 mOsm / L for peripheral venous route and ≤1200 mOsm / L for central venous route; when distributing glucose, amino acids and fat emulsion, the target energy supply ratio is: glucose accounts for 40%-50%, amino acids account for 10%-20%, and fat emulsion accounts for 25%-40%.

[0011] Optionally, in the fourth implementation of the first aspect of the present invention, in step S5, the osmotic pressure is calculated by multiplying the concentration of each component by its corresponding osmotic pressure coefficient and then summing the results to obtain an estimated total osmotic pressure, which is then compared and adjusted with the osmotic pressure safety limit.

[0012] Optionally, in a fifth implementation of the first aspect of the present invention, in step S6, the growth indicators include daily weight, height, and head circumference, and are evaluated by comparing with Fenton's growth curve; the metabolic indicators include at least blood glucose, blood urea nitrogen, and triglycerides.

[0013] A second aspect of this invention provides a calorie-oriented neonatal parenteral nutrition assessment system, comprising: a data input module for inputting individual information, enteral nutrition data, and clinical monitoring data of the newborn; a calculation engine module storing a preset energy level mapping table, a nutrient database, absorption rate parameters, and a core energy balance formula, for automatically executing the entire process from energy level determination to parenteral nutrition formula calculation; an osmotic pressure verification module with a built-in osmotic pressure calculation model and safety limit rules, for verifying the osmotic pressure compliance and providing optimization prompts for the preliminary formula generated by the calculation engine module; a scheme output and report generation module for outputting the final parenteral nutrition formula, including the dosage of each component, total calories, osmotic pressure, and infusion recommendations; and a data storage and tracking module for storing historical calculation schemes and corresponding infant monitoring data.

[0014] Optionally, in the first implementation of the second aspect of the present invention, an intelligent early warning module is further included. The intelligent early warning module is configured to: indicate a risk of insufficient energy when the calculated target calorie value PN of parenteral nutrition is continuously lower than a preset threshold; indicate the need to assess the energy level when the weight gain slope is lower or higher than the target range according to the growth curve; issue a warning when the calculated osmotic pressure of the formula is close to or exceeds the safety limit; and indicate an abnormal EN / PN conversion logic when enteral nutrition increases while parenteral nutrition does not decrease accordingly.

[0015] A third aspect of the present invention provides an electronic device comprising: a memory and at least one processor, the memory storing computer-readable instructions, the memory and the at least one processor being interconnected via a circuit; the at least one processor invokes the computer-readable instructions in the memory to cause the electronic device to perform the steps of the calorie-guided neonatal parenteral nutrition assessment method as described above.

[0016] A fourth aspect of the present invention provides a computer-readable storage medium storing computer-readable instructions that, when executed on a computer, cause the computer to perform the steps of the calorie-guided neonatal parenteral nutrition assessment method as described above.

[0017] Beneficial effects: Compared with the prior art, the calorie-guided neonatal parenteral nutrition assessment method provided by the present invention has the following technical effects: Achieve precise control of energy supply: By setting calories as the primary calculation target, the individualized energy needs of newborns of different gestational ages, weights, and disease states can be proactively and accurately met, avoiding energy deficits or excesses. Optimize fluid management and reduce load risk: While ensuring the target calories, nutritional support can be achieved under strict fluid restriction conditions by strategically utilizing osmotic pressure space, which can significantly reduce complications such as edema, delayed PDA shut-off, and heart failure caused by blindly increasing fluid volume. Promote ideal weight gain pattern: By scientifically regulating the calorie-nitrogen ratio and the energy supply ratio of the three major nutrients, prioritize the growth of lean body mass, reduce simple fat accumulation, and improve long-term metabolic health. Maximizing the clinical value of central venous catheters: The key role of central venous catheters in the safe infusion of hypertonic fluids and the achievement of fluid restriction and high-calorie nutritional support has been clearly proposed and quantified, changing the traditional view of their use as merely a channel; Constructing structured and operational clinical pathways: Transforming the complex process of nutritional assessment into clear steps, formulas, and parameter tables greatly improves the standardization, consistency, and efficiency of clinical work; Reduced medical risks and complications: Precise protocols reduce the overuse of amino acids and fat emulsions, thereby lowering the risk of parenteral nutrition-related cholestasis, liver damage, and metabolic disorders. Supports data-driven dynamic decision-making: By combining growth curves (such as Fenton curves) with metabolic indicators for continuous evaluation and program iteration, dynamic and refined management of nutritional support is achieved. Attached Figure Description

[0018] The accompanying drawings, which are incorporated in and form part of this specification, illustrate embodiments consistent with the invention and, together with the description, serve to explain the principles of the invention.

[0019] To more clearly illustrate the technical solutions in the embodiments of the present invention or the prior art, the drawings used in the description of the embodiments or the prior art will be briefly introduced below. Obviously, for those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0020] Figure 1 This is a flowchart of a calorie-guided neonatal parenteral nutrition assessment method provided in an embodiment of the present invention.

[0021] Figure 2 This is a schematic diagram of a neonatal parenteral nutrition assessment system guided by calories, provided by the present invention.

[0022] Figure 3 This is a schematic diagram of the electronic device structure provided by the present invention. Detailed Implementation

[0023] This invention provides a calorie-guided method and system for assessing neonatal parenteral nutrition. The terms "first," "second," "third," "fourth," etc. (if applicable) in the specification, claims, and accompanying drawings are used to distinguish similar objects and are not necessarily used to describe a specific order or sequence. It should be understood that such data can be interchanged where appropriate so that the embodiments described herein can be implemented in a sequence other than that illustrated or described herein. Furthermore, the terms "comprising" or "having" and any variations thereof are intended to cover a non-exclusive inclusion; for example, a process, method, system, product, or apparatus that comprises a series of steps or units is not necessarily limited to those explicitly listed, but may include other steps or units not explicitly listed or inherent to such processes, methods, products, or apparatus.

[0024] Please see Figure 1 , Figure 1 A flowchart of a calorie-guided neonatal parenteral nutrition assessment method provided by the present invention is shown in the figure, which includes the following steps: S1: Obtain individual information about the newborn, including gestational age, birth weight, age in days, and disease status; Specifically, obtaining individual information about newborns is the starting point for individualized assessment. The information required includes at least: gestational age (reflecting metabolic maturity), birth weight (the basis for calculating all dosages per kilogram of body weight), age in days (affecting fluid requirements and intestinal tolerance), and current disease status (such as the presence of respiratory failure, sepsis, congenital heart disease, patent ductus arteriosus, necrotizing enterocolitis, etc., which can significantly alter energy expenditure and fluid tolerance).

[0025] S2: Based on the individual information, an initial energy level is determined from a plurality of preset energy levels. The energy level is defined by a pair of parameters (A, B), where A represents the target calorie value for total enteral nutrition and B represents the target calorie value for total parenteral nutrition. Specifically, this step is crucial in transforming individual information into computational parameters. This invention predefines multiple energy levels, each uniquely determined by a pair of parameters (A, B). Parameter A represents the target calorie value for total enteral nutrition, and parameter B represents the target calorie value for total parenteral nutrition. Based on the individual information from step S1, an optimal initial (A, B) pair is matched for the current child by querying predetermined mapping rules or a database. For example, a healthy full-term infant might be matched with (110, 80), while a very low birth weight preterm infant might be matched with (140, 110).

[0026] S3: Obtain the actual intake data of current enteral nutrition, and calculate the corrected effective enteral nutrition calorie value EN based on the intestinal absorption rate of different nutrients. Specifically, the core of this step is correction. First, record the types and volumes of all milk consumed by the infant within the current 24 hours. Then, based on the type of milk (e.g., breast milk, standard formula, premature infant formula, extensively hydrolyzed formula, etc.), look up the caloric value per unit volume of the milk and the specific content of glucose, protein (amino acids), and fat in a nutrient database (e.g., the nutrient composition section of commonly used formulas). Next, apply preset intestinal absorption rates (glucose ~100%, amino acids ~80-85%, fat ~50-90%) to calculate the amount of nutrients ingested, obtaining the actual amount that the body can absorb. Finally, calculate the corrected effective caloric value (EN) (unit: kcal / kg·d) based on the absorption amount. This correction process avoids underestimation of enteral nutrition contribution due to neglecting absorption rates.

[0027] S4: Substitute the effective enteral nutrition calorie value EN and the parameters A and B of the selected energy level into the core energy balance formula: 1=EN / A+PN / B, and calculate the current target value PN for parenteral nutrition calorie intake. Specifically, this step applies the core formula of this invention, 1 = EN / A + PN / B. The values ​​of A and B determined in step S2 and the EN value calculated in step S3 are substituted into the formula. Since only PN is unknown in the formula, it can be directly solved: PN = B * (1 - EN / A). The calculated PN value is the target calorie value of parenteral nutrition necessary to make up for the energy gap not provided by EN and to achieve the individualized target level of total energy supply for the child (i.e., formula equals 1). This value becomes the rigid constraint target for all subsequent formula design.

[0028] S5: Using the target calorie value PN for parenteral nutrition as a constraint target, allocate and calculate the dosage of glucose, amino acids and fat emulsion within the preset osmotic pressure safety limit, wherein the osmotic pressure safety limit is set differently depending on whether the infusion route is peripheral vein or central vein; Specifically, this step involves converting the target caloric intake (PN) into a specific intravenous nutrition formula. To achieve the target PN kcal / kg, and while ensuring a reasonable energy supply ratio among glucose, amino acids, and fat emulsion (typically 40-50% glucose, 10-20% amino acids, and 25-40% fat), the initial dosage (g / kg) of each component is calculated. Then, based on the planned concentration of the commercially available formulation (e.g., 50% glucose, 6.74% amino acids, 20% fat emulsion), the required volume of each formulation is calculated. A key constraint is that the calculated osmotic pressure of the mixed nutrient solution must be within the safe upper limit of the selected intravenous access route—typically ≤900 mOsm / L for peripheral veins and ≤1200 mOsm / L for central veins (e.g., PICC, umbilical vein catheters). Osmotic pressure calculations are based on the osmotic coefficients of each component solution. If the initial formulation's osmotic pressure exceeds the limit, the strategy needs adjustment: either replace with a higher concentration formulation to reduce the liquid volume, adjust the composition of the three macronutrients within the permissible ratio, or assess whether switching to a central vein to utilize the higher osmotic pressure limit is feasible. This step embodies the proactive optimization approach that uses heat as the target and osmotic pressure as the boundary.

[0029] S6: Implement the nutritional support plan calculated in step S5, and periodically monitor the newborn's growth and metabolic indicators. Specifically, the formula finalized in step S5 is prepared into a nutrient solution and administered intravenously. Simultaneously, a periodic monitoring plan is established, the core of which is accurate daily weight measurement, and regular measurement of height and head circumference. Plotting these growth data on a Fenton growth chart is the gold standard for evaluating the effectiveness of the nutrition. In addition, metabolic indicators such as blood glucose, blood electrolytes, blood urea nitrogen, triglycerides, and liver function need to be monitored to assess the body's metabolic tolerance to the nutritional regimen.

[0030] S7: Based on the monitoring results, dynamically assess the suitability of the initial energy level, and dynamically adjust to a new energy level based on the assessment results, then return to step S4 for iterative calculation.

[0031] Specifically, nutritional support is not static. Based on the monitoring data from step S6 (especially changes in the slope of the growth curve), the currently selected energy level (A, B) is periodically (e.g., every 3-5 days) assessed to ensure it still matches the child's current growth needs. If weight gain consistently falls short of the expected trajectory, it suggests potential energy insufficiency, and the energy level should be increased (e.g., from (120, 90) to (130, 100)). If weight gain is too rapid, especially accompanied by edema, it suggests potential fluid overload or relative calorie excess, and the energy level should be decreased or fluid restriction strengthened. After determining the new energy level based on the assessment results, the process returns to step S4, where the PN target and formula are recalculated based on the new (A, B) values ​​and the latest EN value, and the next cycle of support begins. This iterative cycle achieves continuous individualized optimization of nutritional support.

[0032] The core of this invention lies in completely overturning the traditional calculation method for neonatal parenteral nutrition. It revolutionarily transforms the calculation logic from a passive model of total fluid volume → nutrient allocation → calorie calculation into an active model of determining target calories → configuring nutrient composition → co-optimizing fluid volume under safe osmotic pressure. Under this new approach, meeting the individualized energy needs of the infant becomes the sole starting point and core objective of the entire nutritional support program design process. To achieve this fundamental shift, this invention constructs a complete, closed-loop assessment method, which includes the following five interrelated and progressively advanced innovative technical components: Personalized energy level model: Transforms the abstract, continuous energy demand spectrum into a series of discrete, optional standardized parameter pairs (A, B). Each pair (A, B) represents a specific energy demand intensity level and establishes a mapping relationship with different clinical characteristics (such as gestational age, weight, and disease), realizing a rapid and standardized conversion from complex conditions to clear calculation parameters. Enteral nutrition absorption correction model: It acknowledges and accurately quantifies the essential differences in nutrient absorption efficiency between the intestinal and venous routes. By setting different intestinal absorption rates for glucose, amino acids, and fats, it corrects the apparent calories ingested in the intestine to the effective calories that the body can actually obtain, laying the foundation for accurately assessing the true contribution of enteral nutrition. The core energy balance formula (1 = EN / A + PN / B): This formula is the soul of this invention. It is not a simple arithmetic equation, but an energy contribution normalization model based on physiological principles. It enables the quantitative comparison and seamless integration of enteral nutrition (EN) with different absorption rates and parenteral nutrition (PN) with high utilization efficiency under a unified and individualized value scale (A and B), and accurately guides the dynamic conversion between EN and PN. Active utilization strategy of osmotic pressure safety boundary: This strategy fundamentally changes the conservative view of osmotic pressure as a simple limiting risk factor, instead viewing it as a key controllable resource for ensuring high calorie supply under strict fluid restriction conditions. By clearly distinguishing and strategically utilizing the different osmotic pressure safety limits of peripheral veins and central veins, a novel technical approach is provided to resolve the core clinical contradiction between fluid restriction and high calorie demand. A dynamic feedback iteration mechanism based on growth curves: The implementation of nutritional support programs is viewed as a continuous closed-loop process of evaluation, execution, monitoring, and adjustment. Using recognized objective growth indicators such as the Fenton growth curve as core evaluation criteria, and combined with metabolic indicators, standardized feedback adjustment rules are established to dynamically optimize energy levels and nutritional plans according to changes in the child's growth status and condition.

[0033] In some implementations, the preset multiple energy levels mentioned in step S2 include, but are not limited to, five levels: (A=110, B=80), (A=120, B=90), (A=130, B=100), (A=140, B=110), (A=150, B=120), with units of kcal / kg·d; the selection criteria for energy levels include: the smaller the gestational age, the lower the birth weight, and the presence of hypermetabolic diseases, the higher the A and B values ​​tend to be selected.

[0034] In this embodiment, these levels constitute an energy supply ladder from low to high. The selection principle is: the smaller the gestational age, the lower the birth weight, and the more metabolic diseases (such as bronchopulmonary dysplasia, severe infection), the higher the infant's basal energy consumption and growth requirements. Therefore, levels with larger A and B values ​​are preferred. For example, a 29-week premature infant might initially be selected at levels (140, 110) or even (150, 120). These specific values ​​are derived from the summary and standardization of a large number of clinical guidelines and research data, providing clear operational guidance.

[0035] In some implementations, in step S3, the set value of the intestinal absorption rate is: glucose 100%, amino acids 80%-85%, and fat emulsion 50%-90%. When calculating the effective enteral nutrition calorie value EN, it is necessary to obtain the calorie and nutrient content per unit volume from the commonly used milk powder nutrient composition area according to the type of milk ingested, and then convert it using the absorption rate.

[0036] This embodiment clarifies the set range of intestinal absorption rate, which is the basis for accurate EN correction. Glucose is almost completely absorbed in the small intestine, so it is set to 100%. Protein (amino acids) needs to be digested and broken down, and the absorption rate is about 80-85%. Fat absorption is the most complex, depending on bile salts and pancreatic enzymes. The absorption rate varies greatly in newborns, especially premature infants, ranging from about 50-90%. When calculating, a median value such as 70% can be used, or it can be slightly adjusted according to feeding tolerance. When calculating, the nutritional composition data of the milk used can be accurately found in the nutritional composition table of commonly used milk powders and converted accordingly.

[0037] In some embodiments, in step S5, the preset osmotic pressure safety limit is: ≤900 mOsm / L for peripheral venous route and ≤1200 mOsm / L for central venous route; when distributing glucose, amino acids and fat emulsion, the target energy supply ratio is: glucose accounts for 40%-50%, amino acids account for 10%-20%, and fat emulsion accounts for 25%-40%.

[0038] This embodiment specifies safe limits for osmotic pressure and target proportions of nutrients for energy supply. The upper limits of 900 mOsm / L for peripheral veins and 1200 mOsm / L for central veins are based on authoritative works such as "Practical Neonatology" and clinical practice safety consensus, providing clear and differentiated safety boundaries for maximizing nutrient solution concentration. A 40-50% glucose energy supply proportion aims to avoid excessively high glucose rates leading to hyperglycemia and lipogenesis; a 10-20% amino acid proportion ensures that protein is used for anabolic metabolism rather than for energy supply; and a 25-40% fat proportion provides space for the supply of essential fatty acids and efficient energy supply. These proportion targets ensure a balanced nutritional structure.

[0039] In some embodiments, in step S5, the osmotic pressure is calculated by multiplying the concentration of each component by its corresponding osmotic pressure coefficient and summing the results to obtain an estimated total osmotic pressure, which is then compared and adjusted against the osmotic pressure safety limit. This embodiment illustrates the method for calculating osmotic pressure, which involves multiplying the concentration of each component (g / 100ml or %) by its specific osmotic pressure coefficient (mOsm / ml) and summing the results to obtain an estimated total osmotic pressure (mOsm / L). The osmotic pressure coefficients of various substances are well-known, for example, 2.78 for 50% glucose and 0.674 for 6.74% amino acids, providing a data basis for automated calculation.

[0040] In some implementations, in step S6, the growth indicators include daily weight, height, and head circumference, and are assessed by comparing them with Fenton's growth curve; the metabolic indicators include at least blood glucose, blood urea nitrogen, and triglycerides.

[0041] This embodiment clarifies the specific indicators for monitoring and evaluation. Daily body weight is the most sensitive indicator reflecting short-term energy balance, and the Fenton growth curve is an internationally standardized tool for assessing whether the growth of preterm infants is catching up with the intrauterine rate and whether extrauterine growth retardation has occurred. Blood glucose reflects the stability of glucose metabolism, blood urea nitrogen indirectly reflects protein intake and catabolism, and triglycerides reflect fat metabolism and clearance capacity. These are the core metabolic windows for assessing the safety and tolerability of nutritional programs.

[0042] The following specific embodiments illustrate the present invention's method for assessing neonatal parenteral nutrition based on calorie intake: Example 1: Transition from initial parenteral nutrition to enteral nutrition in 32-week preterm infants Infant's condition: Gestational age 32+1 weeks, birth weight 1.5kg, day 3. Vital signs are stable, breastfeeding has started, and the plan for today is to feed 20 ml / kg·day of premature infant formula. Central venous access has not yet been established; peripheral venous access is being used.

[0043] Implementation steps: S1 - Information Acquisition: Gestational age 32 weeks, weight 1.5kg, age 3 days, no serious complications.

[0044] S2 - Determine Energy Level: Referring to the preset mapping rules or the nutritional requirement range for newborns in the database table, the enteral target for 32-week premature infants is approximately 110-130, and the parenteral target is approximately 90-100. Based on the energy level classification, for safety reasons, the initial level is selected as (A=120, B=90).

[0045] S3 - Calculate the effective EN: Planned milk volume: 1.5 kg * 20 ml / kg = 30 ml.

[0046] Checking the nutritional components of commonly used infant formula, premature infant formula (such as premature-early Neng'en) has an energy of 80 kcal / 100ml and nutritional components of: glucose 8.34g / 100ml, amino acids 2.32g / 100ml, and fat 4.17g / 100ml.

[0047] Absolute intake: G = 8.34 * (30 / 100) = 2.50g; AA = 2.32 * 0.3 = 0.70g; Fat = 4.17 * 0.3 = 1.25g. (All figures are based on total intake; the values ​​per kilogram are calculated below.) The effective absorption amount was calculated using the absorption rates (G 100%, AA 85%, Fat 70%): G_eff = 2.50g; AA_eff = 0.70 * 0.85 = 0.60g; Fat_eff = 1.25 * 0.70 = 0.88g.

[0048] Calculate the effective calories: EN_corrected = [(2.50*4) + (0.60*4) + (0.88*9)] / 1.5 =(10.0 + 2.4 + 7.9) / 1.5 = 20.3 / 1.5 =13.53 kcal / kg.

[0049] S4 - Calculate the PN objective: Substituting into the formula: PN = B * (1 - EN / A) = 90 * (1 - 13.53 / 120) = 90 * (1 -0.1128) = 90 * 0.8872 = 79.85 kcal / kg.

[0050] Therefore, it is clear that PN needs to provide approximately 80 kcal / kg of calories today.

[0051] S5 - Nutritional Configuration: Target: PN calories 80 kcal / kg.

[0052] The proportions are set as follows: sugar 45%, amino acids 15%, and fat 40%. Therefore: sugar provides 36 kcal of energy, requiring 9.0 g of glucose; amino acids provide 12 kcal of energy, requiring 3.0 g of amino acids; and fat provides 32 kcal of energy, requiring 3.56 g of fat.

[0053] Solution selection: 50% glucose (0.5 g / ml), 6.74% amino acids (0.0674 g / ml), 20% fat emulsion (0.2 g / ml).

[0054] Calculated volume: 50% GS = 9.0 / 0.5 = 18 ml; 6.74% AA = 3.0 / 0.0674 ≈ 44.5 ml; 20% Fat = 3.56 / 0.2 = 17.8 ml. Adding trace amounts of electrolytes, vitamins, etc., the total fluid volume is approximately 85-90 ml / kg (depending on the amount of electrolytes used).

[0055] Osmotic pressure verification (key step): The osmotic pressure coefficients are: 50%GS=2.78, 6.74%AA=0.674, and 20%Fat=0.286.

[0056] Estimate the contribution of major components: Calculate the total osmotic pressure based on the total liquid volume and the milliosmolar number of each component. Assume that the calculated osmotic pressure in this example is 820 mOsm / L.

[0057] Judgment: 820 mOsm / L < peripheral venous safety limit of 900 mOsm / L, the protocol is feasible. If the calculated osmolality is 950, it exceeds the limit, and the system will prompt adjustments, such as slightly reducing the amount of amino acids or fat, or slightly increasing the total fluid volume to dilute the concentration.

[0058] S6 - Administration and Monitoring: Prepare PN according to this formula and administer via peripheral intravenous infusion at a rate of approximately 3.7 ml / h. Weigh daily and monitor blood glucose and electrolytes.

[0059] S7 - Dynamic Adjustment: After one week, the infant's milk intake increased to 60 ml / kg / day, and weight gain was 18 g / day. The Fenton curve was at the 25th percentile and rising in parallel. The increased EN caused the calculated PN requirement to decrease to 40 kcal / kg. At this point, the assessment considered the current energy level (120, 90) to be appropriate, and PN was continued to be calculated based on the new EN value. If weight gain is slow, the level will be adjusted to (130, 100) and reassessed.

[0060] Example 2: High-calorie support under fluid restriction for 28-week extremely preterm infants (demonstrating an osmotic pressure strategy) Patient's condition: Gestational age 28 weeks, birth weight 0.98 kg, 7 days old. Diagnosed with hemodynamically significant patent ductus arteriosus (hsPDA), echocardiography showed left atrial enlargement, requiring strict fluid restriction to 110 ml / kg / day. PICC line has been inserted. Enteral nutrition is minimal.

[0061] Implementation steps: S1 / S2: Extremely premature infants with hsPDA (hypermeability, fluid restriction required), choose a higher energy level (A=140, B=110).

[0062] S3: Micro-feeding, EN_corrected ≈5 kcal / kg.

[0063] S4: PN = 110 * (1 - 5 / 140) = 110 * 0.964 ≈106 kcal / kg, which is a very high calorie target.

[0064] S5 - Configuration and Osmotic Pressure Strategy (Core): Challenge: The total fluid volume is strictly limited to 110 ml / kg. To provide 106 kcal / kg of calories in such a small amount of fluid, a high concentration of nutrient solution must be used.

[0065] Solution optimization: Driven by the computing engine, the system tried various combinations, and the final possible solution is to increase the amino acid concentration to 8.5% (instead of 6.74%), use 30% fat emulsion (instead of 20%), and adjust the glucose concentration appropriately.

[0066] Assuming the optimized formulation has a total liquid volume of 105 ml / kg, containing a high concentration of amino acids and fat emulsion, the system calculates the total calories of this formulation to be 105 kcal / kg, which is close to the target.

[0067] Osmotic pressure verification: The system uses the osmotic pressure coefficient to calculate the osmotic pressure of this high-concentration formulation. The assumed result is 1180 mOsm / L.

[0068] Key judgment: 1180 mOsm / L > peripheral venous limit of 900, but < central venous (PICC) limit of 1200 mOsm / L.

[0069] Conclusion: This high-concentration regimen is safe under PICC access and meets the dual objectives of fluid restriction (105 ml / kg < 110 ml / kg) and high calorie intake (105 kcal / kg). This perfectly embodies the principle emphasized in this invention of overcoming osmotic pressure limitations and maximizing the true function of deep vein catheters. Without a central venous catheter, this objective would be virtually impossible to achieve under strict fluid restriction.

[0070] S6 / S7: Execute this hyperosmolar PN regimen, closely monitoring weight, cardiac function, electrolytes, and liver function. Adjust energy levels and fluid volume gradually based on PDA treatment response and growth.

[0071] In some embodiments, the present invention also provides a calorie-guided neonatal parenteral nutrition assessment system, such as... Figure 2 As shown, it includes: The data input module 10 is used to input the newborn's individual information, enteral nutrition data, and clinical monitoring data; The calculation engine module 20 stores a preset energy level mapping table, nutrient database, absorption rate parameters and core energy balance formula, which is used to automatically execute the entire process from energy level determination to parenteral nutrition formula calculation. The osmotic pressure verification module 30 has a built-in osmotic pressure calculation model and safety limit rules, which is used to verify the osmotic pressure compliance and provide optimization prompts for the preliminary formula generated by the calculation engine module. The protocol output and report generation module 40 is used to output the final parenteral nutrition formula, including the dosage of each component, total calories, osmolarity and infusion recommendations; The data storage and tracking module 50 is used to store historical calculation schemes and corresponding monitoring data of the children. The intelligent early warning module 60 is configured to: indicate a risk of insufficient energy when the calculated target calorie value (PN) of parenteral nutrition is continuously lower than a preset threshold; indicate the need to assess the energy level when the weight gain slope is lower or higher than the target range based on the growth curve; issue a warning when the calculated osmotic pressure of the formula is close to or exceeds the safety limit; and indicate an abnormal EN / PN conversion logic when enteral nutrition increases while parenteral nutrition does not decrease accordingly.

[0072] Specifically, the data input module 10 provides a user-friendly interface for medical staff to input newborns' individual information, enteral nutrition data, clinical monitoring data, milk intake, and test results; the calculation engine module 20 is the brain of the system, containing built-in energy level mapping logic, a nutrient composition database, absorption rate parameters, core formulas, and nutrient ratio algorithms; the osmotic pressure verification module 30 acts as a safety valve, performing real-time osmotic pressure calculations and compliance checks on each preliminary formula proposed by the calculation engine module, and providing adjustment suggestions (such as "osmotic pressure 1050 mOsm / L, exceeding the peripheral venous limit, suggestion: a. Use a central venous catheter; b. ..." The system reduces amino acid concentration to X%). The protocol output and report generation module 40 generates a clearly structured clinical medical order containing all calculation details and infusion parameters. The data storage and tracking module 50 establishes a nutritional therapy file for the child, storing past protocols and monitoring data for trend analysis and research summaries. The intelligent early warning module 60 uses the inherent logic of this invention to provide primary clinical decision support: for example, energy deficiency warning: if the calculated PN target value is extremely low for several consecutive days, but the child's growth is slow, it may indicate that the current A value is set too low, and the system can issue an early warning suggesting an assessment of whether to increase the energy level; abnormal growth warning: the algorithm automatically analyzes the trend of the entered weight data on the Fenton curve, and issues a warning once the growth slope deviates from the expected trajectory; osmotic pressure warning: real-time warning of osmotic pressure risk during formula calculation or adjustment; logical contradiction warning: for example, when enteral feeding volume increases significantly, if the PN reduction calculated according to the formula is abnormally small, it may indicate that the A and B values ​​are set unreasonably or the EN calculation is incorrect, and the system can prompt for verification. These warning functions significantly improve the system's practicality and safety.

[0073] Figure 2 The calorie-guided neonatal parenteral nutrition assessment system in this embodiment of the invention is described in detail from the perspective of modular functional entities. The dynamic partitioning and priority scheduling device based on time-series data in this embodiment of the invention is described in detail from the perspective of hardware processing.

[0074] Figure 3This is a schematic diagram of the structure of an electronic device provided in an embodiment of the present invention. The electronic device 100 can vary significantly due to differences in configuration or performance. It may include one or more central processing units (CPUs) 111 (e.g., one or more processors) and a memory 121, and one or more storage media 130 (e.g., one or more mass storage devices) for storing application programs 133 or data 132. The memory 121 and storage media 130 may be temporary or persistent storage. The program stored in the storage media 130 may include one or more modules (not shown in the diagram), each module including a series of instruction operations on the electronic device 100. Furthermore, the processor 111 may be configured to communicate with the storage media 130 and execute the series of instruction operations in the storage media 130 on the electronic device 100.

[0075] Electronic device 100 may also include one or more power supplies 141, one or more wired or wireless network interfaces 151, one or more input / output interfaces 161, and / or one or more operating systems 131, such as Windows Server, Mac OS X, Unix, Linux, FreeBSD, etc. Those skilled in the art will understand that... Figure 3 The device structure shown does not constitute a limitation on the electronic device 100, and may include more or fewer components than shown, or combine certain components, or have different component arrangements.

[0076] The present invention also provides a computer-readable storage medium, which can be a non-volatile computer-readable storage medium or a volatile computer-readable storage medium, wherein the computer-readable storage medium stores instructions that, when executed on a computer, cause the computer to perform the steps of a dynamic partitioning and priority scheduling method based on time-series data.

[0077] Those skilled in the art will clearly understand that, for the sake of convenience and brevity, the specific working process of the system, device, or unit described above can be referred to the corresponding process in the foregoing method embodiments, and will not be repeated here.

[0078] If the integrated unit is implemented as a software functional unit and sold or used as an independent product, it can be stored in a computer-readable storage medium. Based on this understanding, the technical solution of the present invention, in essence, or the part that contributes to the prior art, or all or part of the technical solution, can be embodied in the form of a software product. This computer software product is stored in a storage medium and includes several instructions to cause a computer device (which may be a personal computer, server, or network device, etc.) to execute all or part of the steps of the methods described in the various embodiments of the present invention. The aforementioned storage medium includes various media capable of storing program code, such as USB flash drives, portable hard drives, read-only memory (ROM), random access memory (RAM), magnetic disks, or optical disks.

[0079] The above-described embodiments are only used to illustrate the technical solutions of the present invention, and are not intended to limit it. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art should understand that modifications can still be made to the technical solutions described in the foregoing embodiments, or equivalent substitutions can be made to some of the technical features. Such modifications or substitutions do not cause the essence of the corresponding technical solutions to deviate from the spirit and scope of the technical solutions of the embodiments of the present invention.

Claims

1. A calorie-based method for assessing neonatal parenteral nutrition, characterized in that, Including the following steps: S1: Obtain individual information about the newborn, including gestational age, birth weight, age in days, and disease status; S2: Based on the individual information, an initial energy level is determined from a plurality of preset energy levels. The energy level is defined by a pair of parameters (A, B), where A represents the target calorie value for total enteral nutrition and B represents the target calorie value for total parenteral nutrition. S3: Obtain the actual intake data of current enteral nutrition, and calculate the corrected effective enteral nutrition calorie value EN based on the intestinal absorption rate of different nutrients. S4: Substitute the effective enteral nutrition calorie value EN and the parameters A and B of the selected energy level into the core energy balance formula: 1=EN / A+PN / B, and calculate the current target value PN for parenteral nutrition calorie intake. S5: Using the target calorie value PN for parenteral nutrition as a constraint target, allocate and calculate the dosage of glucose, amino acids and fat emulsion within the preset osmotic pressure safety limit, wherein the osmotic pressure safety limit is set differently depending on whether the infusion route is peripheral vein or central vein; S6: Implement the nutritional support plan calculated in step S5, and periodically monitor the newborn's growth and metabolic indicators. S7: Based on the monitoring results, dynamically assess the suitability of the initial energy level, and dynamically adjust to a new energy level based on the assessment results, then return to step S4 for iterative calculation.

2. The calorie-guided neonatal parenteral nutrition assessment method according to claim 1, characterized in that, The preset energy levels mentioned in step S2 include, but are not limited to, five levels: (A=110, B=80), (A=120, B=90), (A=130, B=100), (A=140, B=110), (A=150, B=120), with units of kcal / kg·d. The selection criteria for energy levels include: when the gestational age is smaller, the birth weight is lower, or there is a high metabolic disease, a level with larger A and B values ​​is preferred.

3. The calorie-guided neonatal parenteral nutrition assessment method according to claim 1, characterized in that, In step S3, the intestinal absorption rate is set as follows: glucose 100%, amino acids 80%-85%, and fat emulsion 50%-90%. When calculating the effective enteral nutrition calorie value (EN), the calorie and nutrient content per unit volume should be obtained from the commonly used milk powder nutrient composition area according to the type of milk ingested, and the absorption rate should be used for conversion.

4. The calorie-guided neonatal parenteral nutrition assessment method according to claim 1, characterized in that, In step S5, the preset osmotic pressure safety limit is: ≤900 mOsm / L for peripheral venous route and ≤1200 mOsm / L for central venous route; when distributing glucose, amino acids and fat emulsion, the target energy supply ratio is: glucose accounts for 40%-50%, amino acids account for 10%-20%, and fat emulsion accounts for 25%-40%.

5. The calorie-guided neonatal parenteral nutrition assessment method according to claim 1, characterized in that, In step S5, the osmotic pressure is calculated by multiplying the concentration of each component by its corresponding osmotic pressure coefficient and summing the results to obtain an estimated total osmotic pressure, which is then compared and adjusted with the osmotic pressure safety limit.

6. The calorie-guided neonatal parenteral nutrition assessment method according to claim 1, characterized in that, In step S6, the growth indicators include daily weight, height, and head circumference, and are evaluated by comparing them with Fenton's growth curve; the metabolic indicators include at least blood glucose, blood urea nitrogen, and triglycerides.

7. A calorie-oriented neonatal parenteral nutrition assessment system, characterized in that, include: The data input module is used to enter newborns' individual information, enteral nutrition data, and clinical monitoring data; The calculation engine module stores a preset energy level mapping table, nutrient database, absorption rate parameters and core energy balance formula, which is used to automatically execute the entire process from energy level determination to parenteral nutrition formula calculation. The osmotic pressure verification module has a built-in osmotic pressure calculation model and safety limit rules, which is used to verify the osmotic pressure compliance and provide optimization suggestions for the preliminary formula generated by the calculation engine module. The protocol output and report generation module is used to output the final parenteral nutrition formula, including the dosage of each component, total calories, osmolarity, and infusion recommendations; The data storage and tracking module is used to store historical calculation schemes and corresponding monitoring data of the children.

8. The system according to claim 7, characterized in that, It also includes an intelligent early warning module, which is configured to: indicate a risk of insufficient energy when the calculated target calorie value (PN) of parenteral nutrition is continuously lower than a preset threshold; indicate the need to assess the energy level when the weight gain slope is lower or higher than the target range based on the growth curve; issue a warning when the calculated osmotic pressure of the formula is close to or exceeds the safety limit; and indicate an abnormal EN / PN conversion logic when enteral nutrition increases while parenteral nutrition does not decrease accordingly.

9. An electronic device, characterized in that, It includes a memory and at least one processor, wherein the memory stores computer-readable instructions; The at least one processor invokes the computer-readable instructions in the memory to perform the steps of the calorie-guided neonatal parenteral nutrition assessment method as described in any one of claims 1-6.

10. A computer-readable storage medium storing computer-readable instructions thereon, characterized in that, When the computer-readable instructions are executed by a processor, they implement the steps of the calorie-guided neonatal parenteral nutrition assessment method as described in any one of claims 1-6.

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