Medical & Clinical Reviews

Parenteral Nutrition in Hospitalized Children

Objective: Parenteral Nutrition (PN) is prescribed to children with a non functioning gut or to those who fail to meet their nutritional requirements enterally. Complications should be balanced against the benefit for the patient. The aim of this study was to establish if the indications for PN prescribing in a tertiary referral children’s hospital were appropriate.
Study Design: Children and newborns (infants <4 weeks of age) receiving inpatient PN between October 2013 and March 2014 were enrolled and data was collected prospectively. The appropriate indications for the use of PN were based on the 2005 guidelines by the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN).
Results: 303 children (67 newborns) were enrolled. Patients were referred from different departments across the hospital. The median duration of PN was 18 days (1-160). PN was mainly prescribed to critically ill children on intensive care (66/303), those ungergoing surgery (63/303) and bone marrow transplantation (28/303). The ESPGHAN recommendations were followed in 91.7% (278/303) of cases (newborns 64/67, 95.5%; children 214/236, 90.8%). The use of PN was considered inappropriate in 12/303 patients and in 13/303 it was not possible to reach a conclusion.
Conclusion: Although the indications for inpatient PN in children is mostly justified, there is still a proportion of patients receiving intravenous nutrition unnecessarily highlighting the need for more PN training and better access to nutritional support teams.

Author(s):

Mantegazza C, Landy N, Hill SM, Zuccotti GV and Koglmeier J

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