Parenteral nutrition supplements

How it works

They deliver nutritional substrate directly into the bloodstream, bypassing the gastrointestinal tract to maintain energy balance, protein synthesis and micronutrient stores.

Prescribing in practice

• Refeeding syndrome is a key hazard in malnourished or fasted patients; introduce feeding cautiously and correct electrolytes (particularly phosphate, potassium and magnesium) and give thiamine before and during initiation.
• Formulations are typically administered via a dedicated central venous catheter under strict aseptic conditions because of high osmolarity and infection risk.
• Compounding and prescribing should follow specialist nutrition team input and current prescribing references, with tailoring to fluid, electrolyte and organ-function status.

Monitoring

Monitor fluid balance, electrolytes (including phosphate, potassium and magnesium), glucose, liver function, triglycerides and nutritional markers, frequently at initiation and then as the patient stabilises.

Counselling the patient

• Explain to the team that line care and aseptic technique are essential to reduce catheter-related bloodstream infection.
• Highlight that abrupt cessation can cause rebound hypoglycaemia, so the rate should be reduced gradually.

Evidence & guidelines

NICE guidance on nutrition support in adults underpins assessment for parenteral nutrition and prevention of refeeding syndrome.