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Chairman and Editor: Dr CR Pennington.
Summary and Recommendations
- PN should be used to prevent or treat malnutrition when the intestine is unavailable, or the intestinal function is inadequate. Treatment should be initiated before malnutrition has developed.
- Peripheral PN should be used, when venous access is available, for the majority of patients who require short term treatment. Some patients, including those with prolonged intestinal failure, need central PN.
- The nutrient prescription should reflect the estimated nutritional requirement and the patients clinical condition. Most patients can be treated with one of a range of standard nutrient solutions using AII-ln-One regimens.
- The administration of nutrients in excess of estimated need is wasteful and potentially dangerous.
- The nutrition support pharmacist must be consulted about unusual requirements and the possible addition of drugs or other additives when the stability of the emulsion must be confirmed.
- All patients who receive parenteral nutrition must be carefully monitored. Monitoring should include clinical, laboratory, and nutritional parameters.
- Transfer from PN to enteral or oral feeding should be gradual, supervised by a dietitian, with decreasing PN as the enteral nutrition is increased.
- Protocols are necessary for the safe administration of PN, and for the management of complications arising from the use of this treatment.
- Nutrition support teams are desirable to ensure safe and cost-effective management, they are essential for the supervision of Home PN.