Parenterale Ernährung von Kindern und Jugendlichen: Empfehlungen und Experten-Statements: Essentials der S3-Leitlinie der Deutschen Gesellschaft für Ernährungsmedizin (DGEM) in Zusammenarbeit mit der Gesellschaft für Klinische Ernährung der Schweiz (GESKES), der Österreichischen Arbeitsgemeinschaft für Klinische Ernährung (AKE), der Deutschen Gesellschaft für Kinder- und Jugendmedizin (DGKJ) sowie der Gesellschaft für Neonatologie und Pädiatrische Intensivmedizin (GNPI)

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.