Paediatric parenteral nutrition: current issues.

Area of Science:

• Pediatric Gastroenterology
• Neonatology
• Nutritional Support

Background:

• Parenteral nutrition (PN) significantly improved outcomes for pediatric patients with intestinal failure.
• PN adoption in preterm infants, necessitated by immature gastrointestinal function, led to this group becoming the largest recipients.
• Despite advancements, complications such as central venous catheter-related sepsis, thrombosis, liver disease, bone disease, and metabolic disturbances persist.

Purpose of the Study:

• To summarize key elements of the updated European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) guidelines on parenteral nutrition.
• To highlight changes and advancements in PN best practices since the 2005 guidelines.
• To address persistent challenges in PN for pediatric and preterm populations.

Main Methods:

• Review of scientific literature and clinical experience.
• Development of evidence-based recommendations by ESPGHAN and collaborating organizations.
• Comparison of updated 2018 guidelines with the initial 2005 guidelines.

Main Results:

• Guidelines have evolved based on scientific knowledge and clinical experience over 10+ years.
• Focus on reducing risks associated with PN, though challenges remain.
• Updated recommendations aim to promote best practices in PN for vulnerable pediatric populations.

Conclusions:

• Parenteral nutrition remains a vital support for infants and children with intestinal failure.
• Continuous updates to guidelines are necessary to manage and mitigate PN-associated complications.
• The 2018 guidelines represent an advancement in optimizing PN strategies, building upon decades of experience.