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Research Articles

Anez-Bustillos L, Dao DT, Baker MA, Fell GL, Puder M, Gura KM. Intravenous Fat Emulsion Formulations for the Adult and Pediatric Patient: Understanding the Differences. Nutr Clin Pract. 2016 Oct;31(5):596-609. doi: 10.1177/0884533616662996. Epub 2016 Aug 16. Review. PubMed PMID: 27533942; PubMed...

Energy, Fluid, Acid-Base & Electrolyte Management

Parenteral nutrition energy support titration - Titrate PN support to enteral advancement as dictated per primary team. - For patients with no anticipated advancements in enteral feeds, consider serial physiological advancements in PN to maintain normal growth/development. - If weight/height...

Glucose

Approximately 60% of non-protein energy should be supplied as carbohydrates. Aim to maintain normal blood sugar levels (between 80-110 mg/dl, at least PN cycling Infants at around 2 months-old can often tolerate cycling. Taper on by starting with one half the hourly rate for 30 to 60 minutes. Taper...

Intravenous Lipid Emulsions

Maximal daily provision = 2-2.5 g/kg/day CAUTION: If providing >2 gram/kg/day (Weight risks/benefits with attending physician and family) Maximal infusion rate of 0.15-0.17 mg/kg/hour Maximal lipid-to-energy ratio of 25%. Types of intravenous lipid emulsions ilipids available in the US: Intralipid...

Reach

Social media Telemedicine Quality improvement Pre-discharge briefing meeting Simulation Course

Answer 11

5 year-old female with HPN dependence secondary to meconium pseudo-cyst develops acute agitation, headaches and vomiting immediately upon infusing HPN, which is a new batch from that was delivered yesterday. Of note, there have been no recent HPN prescription changes. Patient lives with parents in a...

Answer 12

You are consulted as the HPN expert by the inpatient cardiology team to facilitate discharge for a 3 year-old female with a history of heart transplant for hypoplastic left heart syndrome was admitted for new onset 3-week history of vomiting, diarrhea and weight loss. Diagnostic laboratory and...