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Paediatric Parenteral Nutrition Tool

Results

Element Value

*avoid more than 3.5 g/kg/day
#should be accompanied by non-protein intake of >65 kcal/kg/day and adequate micronutrient intake
**gradually increase

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Further information:

ESPGHAN has published further guidelines on paediatric parenteral nutrition on the topics listed below. Please note the links open PDF guidelines in a separate window which are optimised for viewing on a desktop computer, rather than a mobile device.

Complications in Paediatric Parenteral Nutrition

This Guideline handles the following areas where complications during parenteral nutrition may arise: central venous catheter (CVC) related complications including infection, occlusion, central venous thrombosis, pulmonary embolism and accidental removal or damage; admixture stability; interactions between parenteral nutrition and medications; metabolic bone disease; hepatobiliary complications; and effects of parenteral nutrition on growth parameters.

To view the guideline, please click here.

Parenteral Nutrition at Home

Home parenteral nutrition (Home PN) is the best alternative to prolonged hospitalisation and the best option for improving the quality of life of children dependent on long-term parenteral nutrition. In this Guideline, ESPGHAN discuss indications, organisational aspects, requirements, follow-up, complications, quality of life and long-term outcome of Home PN.

To view the guideline, please click here.

Venous Access in Parenteral Nutrition

Securing reliable venous access is of paramount importance when considering parenteral nutrition (PN). However, the presence of a CVC is the principal risk factor for major, potentially lethal complications, such as nosocomial bloodstream infection and venous thrombosis. Notably, a large proportion of complications are preventable by means of appropriate catheter choice, selection of site and method of insertion, nursing care, handling and hygiene of venous access, all of which are addressed in this Guideline.

To view the guideline, please click here.

Organisational Aspects of Parenteral Nutrition

Having identified a patient in need of PN, the process of ordering and monitoring is aimed at ensuring safe and effective nutritional support. Provision of PN should be part of an overall nutritional care plan that includes detailed nutritional assessment. Nutritional goals should be set, and an estimate made of the probable duration of PN. This Guideline outlines the organisational recommends for parenteral nutrition.

To view the guideline, please click here.

Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children with Neurological Impairment

Feeding difficulties are frequent in children with neurological impairments and can be associated with undernutrition, growth failure, micronutrients deficiencies, osteopenia, and nutritional comorbidities. Gastrointestinal problems including gastroesophageal reflux disease, constipation, and dysphagia are also frequent in this population and affect quality of life and nutritional status. In this Guideline, ESPGHAN aims to develop uniformity in the management of the gastroenterological and nutritional problems in children with neurological impairment.

To view the guideline, please click here.

Standard versus Individualised Parenteral Nutrition

PN can be provided as a standard, usually commercial, formulation that is designed to meet the nutritional needs of most patients of the same age group with a similar condition. Alternatively, an individually tailored PN formulation, adapted to the individual patient’s nutritional needs, can be prescribed. Both types of PN preparations have advantages and disadvantages which is discussed in this Guideline.

To view the guideline, please click here.