Parenteral nutrition
Parenteral nutrition supplements
Adult dose
Dose: Individualised by body weight, electrolyte status, energy requirement, organ function — refer to local PN service
Route: IV (central preferred for prolonged)
Frequency: continuous
Clinical pearls
- Failed/unable enteral feeding for ≥7 days (or sooner if severely malnourished)
- NICE NG32 — refeeding-syndrome screen and treat first
Contraindications
- Hypersensitivity to components
- Severe metabolic decompensation
Side effects
- Refeeding syndrome
- Hyperglycaemia
- Hypertriglyceridaemia
- Cholestasis (long-term)
- CRBSI (central line)
- Electrolyte derangement
Interactions
- Drug-PN incompatibilities — separate lumens
Monitoring
- U&E
- LFTs
- Glucose
- Lipids
- Mg/Phos
- Trace elements
- Daily fluid balance
Reference: BNF; NICE NG32; BAPEN; https://bnf.nice.org.uk/drugs/parenteral-nutrition-supplements/. Verify against your local formulary and the latest BNF before prescribing.
Related
Curated clinical cross-links plus same-class fallbacks.
Calculators
- NUTRIC Score for ICU Nutrition Risk · Nutrition
- Harris-Benedict Equation — Resting Energy Expenditure · Nutrition
- MUST Score (Malnutrition Screening) · Nutrition
- Nutritional Risk Index (NRI) · Nutrition
- Mini Nutritional Assessment (MNA) · Nutritional Assessment
- MUST — Malnutrition Universal Screening Tool · Nutrition
Pathways
- Lower Gastrointestinal Bleed · BSG 2019; NICE NG141
- Variceal Upper GI Bleed · BSG 2015; Baveno VII (2022)
- Spontaneous Bacterial Peritonitis (SBP) · BSG / EASL 2018
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Hepatic Encephalopathy · EASL 2014; West Haven criteria
- Clostridioides difficile Colitis · NICE NG199 (2021); IDSA/SHEA 2021