Parenteral Nutrition (PN)

Why is parenteral nutrition important for preterm infants?

This factsheet, directed to healthcare professionals, provides an overview of the components of parenteral nutrition, highlights the difference between and the respective benefits of individualised and standardised parenteral nutrition and guides through the process from indication to administration. Furthermore, the barriers and risk management with regards to the implementation of parenteral nutrition as well as possibilities of communication with parents are presented.

The factsheet can be downloaded here free of charge.

The use of standardised or individual parenteral nutrient (PN) solutions is a much-debated subject in neonatal clinical practice. In Sweden – when it comes to applying PN solutions in neonatal nutritional care – standardised solutions are already the standard approach. The individual PN solution is nevertheless used when patients require individualised nutritional care. In an interview with pharmacist Dr. Mattias Paulsson from Uppsala University Hospital, we had the opportunity to find out how this implementation process of standardised PN took place, what the reasons and the preconditions were to take this step, and how it affects the day-to-day running of clinical units. Learn more about this intriguing topic and watch the full interview.

Also available with German subtitles – auch mit deutschem Untertitel verfügbar!

When a baby is born preterm and has health problems, parents worry incessantly. This was also the case for Gigi Khonyongwa-Fernandez, whose son was in the NICU after being born in gestational week 24 and had to be fed parenterally. In addition to the worries about his development, there were also many questions about his treatment. In this interview, she shares her experiences and encourages parents and healthcare professionals to communicate openly with each other.

Find our playlist of interviews on parenteral nutrition here

Are you aware that there are European guidelines on pediatric parenteral nutrition which contain evidence-based recommendations across the entire provisioning process, from the indication to the composition of solutions until the administration?

This interactive infographic shows which evidence-based recommendations – from determining the need for parenteral nutrition to prevention of complications – are contained in the guidelines and should be implemented in everyday clinical practice to ensure the safe implementation of parenteral nutrition therapy for preterm and sick newborns.

When it comes to parenteral nutrition for preterm or sick newborns, there are two approaches: individualised and standardised parenteral nutrition. According to clinical guidelines, using standardised solutions should be preferred over the use of individualised solutions, even for newborns with higher nutrient demands, like those with very low birth weight. For most preterm and sick newborns, standardised solutions can replace individualised formulas, covering the newborn’s needs effectively.

Parenteral nutrition expert Dr Mattias Paulsson emphasises in his statement the benefits of standardised parenteral nutrition and explains additional advantages.

In parenteral nutrition, nutrients are injected directly into the bloodstream, bypassing the digestive system. Therefore, intravenous access is established via special catheters. Ultimately, it is important to use the correct delivery site to avoid associated complications such as contamination, blockage of the catheter, problematic interactions of the applied solution and thrombosis, all of which can lead to serious comorbidities such as bloodstream infections or sepsis.

Parenteral nutrition expert Prof Nadja Haiden explains in her statement which delivery site should be preferred based on the current guideline recommendation.

Parenteral nutrition is a high-alert medication. It should be manufactured in qualified production facilities that ensure high quality standards to guarantee sterility, shelf life and ultimately balanced and safe nutritional support.

Parenteral nutrition expert Dr Mattias Paulsson emphasises in his statement the importance of a qualified administration to promote growth, recovery, and overall health in preterm and sick newborns.

Parenteral nutrition therapy for infants is administered via a catheter, whereby the application of the solutions is the responsibility of the nursing staff for reasons of hygiene. Due to these circumstances, there is still a misconception that parents cannot support their infant’s parenteral nutrition therapy.

Parenteral nutrition expert Prof Nadja Haiden explains in her statement why, contrary to this misconception, parents play a crucial role in their baby’s nutritional therapy and have a decisive influence on the overall success of the treatment.

Parenteral nutrition is a life-saving treatment for preterm or critically sick infants. Given the potential risks associated with this high-alert medication, a robust infrastructure is essential. This includes a multidisciplinary nutrition team that can effectively coordinate routine procedures and ensure optimal, safe and guideline-compliant parenteral nutrition.

This explanatory video outlines the individual steps from assessing needs to administration and targeted evaluation.