Binkley S Daniell and G L Jensen Vanderbilt

Center for Human Nutrition, Nashville, TN, USA

© 2005 Elsevier Ltd. All rights reserved.

Parenteral nutrition (PN) is a compounded formulation of amino acids, dextrose, and lipid emulsions, along with electrolytes, multivitamins, and trace elements. The development of this form of nutrition intervention gave new hope to patients who suffered from intestinal compromise or failure.

PN had its modern beginnings in the mid-1960s as Dr. Stanley Dudrick and colleagues researched infusion of hypertonic glucose and protein solutions into the superior vena cava of beagle puppies. Normal growth and development of the beagles were maintained for 36 months using this approach. The first research that established the use of intravenous feedings in humans was reported by Dudrick and colleagues in 1969. From its early beginnings, PN was known as 'hyperalimentation,' with the belief that it was desirable to feed in excess of standard requirements. Years of clinical practice has shown that PN should be provided in more limited amounts in order to prevent some of the complications associated with its overzealous use.

This article focuses on components of PN for adult nutrition support, indications and contraindications for its use, implementation and monitoring for safety and efficacy, complications associated with use of PN, and consideration of its use for home patients. Prudent patient selection and careful monitoring will help to ensure the safe and effective administration of PN. A multidisciplinary approach to PN management is suggested to help optimize the use of this therapy.

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