Implementing parenteral nutrition (PN) in pediatric patients poses special challenges which arise from the wide range of patient conditions, ranging from extremely premature infants up to teenagers weighing over 100 kg and the varying substrate requirements. In addition age and maturity-related changes of the metabolism and fluid and nutrient requirements must be taken into consideration, along with the clinical situation during which PN is applied. The indications, the procedure as well as the intake of fluid and substrates are very different to that known in PN practice for adult patients, e.g. the fluid, nutrient and energy intake of premature infants and newborns per kg body weight is increased compared to older pediatric and adult patients. All premature infants born after < 35 weeks of pregnancy and most ill term infants require full or partial PN. In neonates the actual amount of PN administered must be calculated (not estimated). Enteral nutrition should be gradually introduced and should replace PN as quickly as possible in order to minimise any side effects from exposure to PN. Inadequate substrate intake in early infancy can cause long-term detrimental effects in terms of metabolic programming of the risk of illness in later life. In school-age children and adolescents who receive an oral or enteral intake that, however, does not approach their energy and nutrient demands, partial or total PN should be considered no later than after 7 days, taking nutritional status and clinical conditions into account.
|Translated title of the contribution||Parenteral nutrition in paediatric and adolescent medicine: recommendations and expert statements: Essentials of the S3 guidelines of the German Society for Nutritional Medicine (DGEM) in cooperation with the Swiss Society for Clinical Nutrition (GESKES), the Austrian Society for Clinical Nutrition (AKE), the German Society of Pediatrics and Adolescent Medicine (DGKJ) and the German Society for Neonatology and Pediatric Intensive Care Medicine (GNPI)|
|Journal||Monatsschrift fur Kinderheilkunde|
|Number of pages||14|
|Publication status||Published - 02.2015|
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)