total parenteral nutrition

home parenteral nutrition

refeeding syndrome

Clinical Nutrition

Literature Search Timeframe: 2004 – 11/2014, in addition relevant earlier publications were considered. Type of publications: randomized controlled studies; case-control or cohort studies; case reports; case series; expert opinion. Key words: Parenteral Nutrition; Infusions, Parenteral; Trace Elements; Chromium; Copper; Iodine; Iron; Manganese; Molybdenum; Selenium; Zinc; Age: Child, infant, preterm Language: English. 152 abstracts were found. Of these, 69 full text papers were assessed. In addition to the retrieved papers the authors found a few additional papers by hand search. Tabled 1R 7.1In patients receiving PN, iron supplementation should preferentially be given enterally rather than parenterally, if tolerated. (LoE 4, RG 0, strong recommendation, strong consensus)R 7.2Routine provision of iron in parenteral nutrition should not be given for short term PN (<3 weeks) (LoE 4, RG 0, conditional recommendation, strong consensus)R 7.3Patients receiving long-term PN, who cannot maintain adequate iron status using enteral iron supplements, should receive parenteral iron supplementation. (LoE 4, RG 0, strong recommendation, strong consensus)R 7.4Parenteral iron can be given daily added to PN solution or as intermittent, separate infusions. (GPP, conditional recommendation, strong consensus)R 7.5If given daily, and assuming no enteral iron supplementation, routine parenteral iron supplements should be given at a dose of 200–250 μg/kg/day in preterm infants and 50–100 μg/kg per day up to a maximum dose of 5 mg/day in infants and children. (LoE 4, RG 0, conditional recommendation, strong consensus)R 7.6Even though currently no intravenous iron preparation is approved for pediatric use in Europe, iron sucrose is the most studied iron preparation in children, severe adverse events are rare and it is approved in the USA for use in children from 2 years of age. It is therefore recommended for intermittent infusions. (LoE 3, RG 0, strong recommendation, strong consensus)R 7.7Iron status (at least ferritin and hemoglobin) ...

ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: Iron and trace minerals