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Initiation, Advancement, and Acute Complications of Parenteral Nutrition


Denise Jezerski, RD, LD, CNSC


Once parenteral nutrition (PN) has been chosen as the optimal or neces- sary route of nutrition support, the clinician must consider many vari- ables to safely and effectively initiate and advance PN. The clinician must also consider the many short-term complications that can develop; an important element of managing PN is to anticipate, prevent, and address these complications.


Nutrition Assessment


PN must be thought of as a high-risk medical therapy that should only be used following careful consideration of all other feeding options.1-3


It is


never appropriate to initiate PN without first obtaining a comprehensive assessment of the patient’s nutritional status.4-8 tion assessment includes the following parameters9


A comprehensive nutri- :


ƒ food- and nutrition-related history ƒ client history ƒ anthropometric measurements ƒ indirect calorimetry, when available


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