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Management of Parenteral Nutrition in Hospitalized Adult Patients [Formula: see text].

Authors
  • Mundi, Manpreet S1
  • Nystrom, Erin M2
  • Hurley, Daniel L1
  • McMahon, M Molly1
  • 1 1 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Mayo Clinic, Rochester, Minnesota, USA.
  • 2 2 Department of Pharmacy, Mayo Clinic, Rochester, Minnesota, USA.
Type
Published Article
Journal
JPEN. Journal of parenteral and enteral nutrition
Publication Date
May 01, 2017
Volume
41
Issue
4
Pages
535–549
Identifiers
DOI: 10.1177/0148607116667060
PMID: 27587535
Source
Medline
Keywords
License
Unknown

Abstract

Despite the high prevalence of malnutrition in adult hospitalized patients, surveys continue to report that many clinicians are undertrained in clinical nutrition, making targeted nutrition education for clinicians essential for best patient care. Clinical practice models also continue to evolve, with more disciplines prescribing parenteral nutrition (PN) or managing the cases of patients who are receiving it, further adding to the need for proficiency in general PN skills. This tutorial focuses on the daily management of adult hospitalized patients already receiving PN and reviews the following topics: (1) PN basics, including the determination of energy and volume requirements; (2) PN macronutrient content (protein, dextrose, and intravenous fat emulsion); (3) PN micronutrient content (electrolytes, minerals, vitamins, and trace elements); (4) alteration of PN for special situations, such as obesity, hyperglycemia, hypertriglyceridemia, refeeding, and hepatic/renal disease; (5) daily monitoring and adjustment of PN formula; and (6) PN-related complications (PN-associated liver disease and catheter-related complications).

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