Indications for parenteral nutrition 87

Parenteral nutrition regimens 87

Parenteral nutrition products 89

Monitoring of parenteral nutrition 93

Complications and their management 94

Parenteral nutrition (PN) is the supply of nutrients directly into a vein. The first case report of successful long-term PN (in an infant with small-bowel atresia) was published in 1968; since that time products for PN have been developed and refined with the result that metabolic complications are less common, and use in clinical practice has become widespread. For children with short-bowel syndrome, protracted diarrhoea, or pseudo-obstruction PN has become a life-saving intervention. Although it is also widely used in the premature infant with immaturity of gastrointestinal function, the benefit in these patients is less well defined. This is reflected by wide variation in the approach to PN support on different neonatal units. The main indication for PN is when nutritional status cannot be maintained or restored to normal using enteral feeding....