Submitted to: Book Chapter
Publication Type: Book / Chapter
Publication Acceptance Date: 11/13/2006
Publication Date: 5/23/2007
Citation: Shulman, R.J., Phillips, S. 2007. Parenteral nutrition indications, administration, and monitoring. In: Baker, S.S., Baker, R.D., Davis, A. M., editors. Pediatric Nutrition Support. Boston, MA, Jones and Barlett Publishers. p. 273-285. Interpretive Summary:
Technical Abstract: Parenteral nutrition (PN) can be lifesaving or life threatening, depending on when and how it is used. In infants and children who are unable to meet their nutritional requirements over extended periods, it can prevent death from malnutrition. On the other hand, if appropriate attention is not paid to the mechanical aspects of administration (e.g., catheter placement) or nutritional requirements (e.g., hypophosphatemia related to nutritional rehabilitation), death from iatrogenic causes can occur. Although PN often is thought of in terms of providing all nutritional support (i.e., total parenteral nutrition), it should be considered in situations where some nutritional needs can be met orally and/or enterally for extended periods of time. It is always important to maintain oral intake so that infants do not lose the desire or ability to feed. Oral and enteral intake also provide nutrients in direct contact with the gastrointestinal (GI) tract, which helps to maintain GI mucosal integrity and potentially decreases bacteria and bacterial product translocation across the GI mucosa.