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5 year-old male with long-term HPN dependence secondary to short bowel syndrome is seen for routine follow-up. Enteral tolerance is currently maximized. PN currently providing energy 45 kcal/kg/day, protein 1.3 gram/kg/day, IV soybean lipids 1 gram/kg/day, glucose infusion rate 10 mg/kg/minute...

Home Parenteral Nutrition ProgramBoston Children’s Hospital300 Longwood AvenueBoston, MA 02115 Telephone: 617-355-6439Fax: 617-730-4722Pager: 617-355-6000 #3226 HPN@childrens.harvard.edu Join our Facebook community.

Discharge Criteria for new HPN referral Patient selection: 2 weeks before discharge HPN Team consulted by primary service. Primary GI, inpatient nutrition attending and inpatient dietitian agrees to referral. Defined indication for HPN (e.g., SBS, severe malabsorption, fistula, GI obstruction, IBD...

Parenteral Amino Acids Solutions Fluids & Electrolyte Disorders (including renal complications) Micronutrient Disorders Iron Deficiency Anemia (including travenous iron) Pharmacy Reconciliation (including stability issues) Growth & Development Bone Health Body Composition Specific Digestive...

Central line occlusion Review of the Line History (These questions are relevant in determining appropriate treatment of the occlusion.) Complete the line history before activating the algorithm. What happened immediately before the line occluded? · Was IV fluid infusing? · Was the line used for...

Assessment of hydration - Heart rate (bpm) o Newborn – 3 months: 85 - 205 o 3 months – 2 years: 100 - 190 o 2 years to 10 years: 60 - 140 o >10 years: 60 - 100 - Weight o Infant scale age o Standing scale age >2 year o Helpful to document which scale was used for consistency - Physical exam findings...

Malnutrition Waterlow Criteria (wt/ht % std = degree of wasting) 80 % - 89 % Mild 70 % - 79 % Moderate Severe 90 - 110 Normal Variation 110 - 120 Overweight > 120 Obese Malnutrition Symptoms: Irritability Apathy Decreased social responsiveness Anxiety Attention deficits Malnutrition physical signs...