Related Experiment Video
Updated: Aug 8, 2025
A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition
Published on: September 20, 2019
Evaluation of non-infectious complications in children receiving parenteral nutrition
Zeynelabidin Ozturk1, Hulya Demir2, Asuman Nur Karhan2
1Department of Pediatrics, Hacettepe University School of Medicine, Sihhiye, 06100, Ankara, Turkey. zeynelabidin_ozturk@hotmail.com.
Insights
Parenteral nutrition (PN) in children requires close monitoring of electrolytes, especially during the first three days, to prevent complications. Individualized PN can help maintain stable blood glucose, lipids, and electrolytes in unstable patients.
Area of Science:
- Pediatric Gastroenterology
- Clinical Nutrition
- Critical Care Medicine
Background:
- Parenteral nutrition (PN) is essential for pediatric patients unable to receive enteral nutrition.
- However, PN can lead to significant metabolic and mechanical complications.
- Identifying and mitigating these risks is crucial for patient outcomes.
Purpose of the Study:
- To investigate the indications for PN in children.
- To evaluate the metabolic and mechanical complications associated with PN.
- To assess the impact of individualized PN on patient growth and stability.
Main Methods:
- A retrospective analysis of 179 PN episodes in 158 children over two years.
- Data collected included indications, duration, growth parameters, and metabolic/catheter-related complications.
- Specific focus on electrolyte imbalances, liver function, and catheter thrombosis.
Main Results:
- Common indications included hematological malignancies, GI surgery, and stem cell transplantation.
- Frequent metabolic complications were hypophosphatemia (44.7%), hypomagnesemia (43.0%), and hypokalemia (43.0%).
- Liver transaminase elevation occurred in 22.1% and bilirubin in 21.0%; ursodeoxycholic acid showed benefit in some cases. Catheter thrombosis was observed in 4.5%.
Conclusions:
- Early monitoring of electrolytes within the first three days of PN is critical.
- Individualized PN formulations facilitate better control of blood glucose, lipids, and electrolytes in metabolically unstable children.
- Effective PN management can support growth and minimize complications.
Background:
Parenteral nutrition may lead to inevitable complications.
Aims:
To determine the indications, metabolic and mechanical complications of parenteral nutrition in children.
Methods:
One hundred fifty-eight children (91 males; 57.8%) who received 179 episodes of individualized parenteral nutrition for ≥ 5 days within 2 years were analyzed. Indications and duration of parenteral nutrition, effect on growth, and metabolic and central venous catheter-related non-infectious complications were evaluated.
Results:
Parenteral nutrition was administered in 179 different episodes (109 males; 60.9%), and the median age during these episodes was 64.0 (14.0-129.0) months. The most common indications were hematological malignancies, gastrointestinal surgery, and hematopoietic stem cell transplantation. Most of the electrolyte imbalances occurred in the first 3 days. Hypophosphatemia (44.7%), hypomagnesemia (43.0%), hypokalemia (43.0%), hyponatremia (40.8%), and hypertriglyceridemia (38.2%) were the most common metabolic complications. Liver transaminases elevated in 32/145 (22.1%) episodes and bilirubin in 30/149 (21.0%). Ursodeoxycholic acid treatment was added to 25 patients with hypertransaminasemia and/or hyperbilirubinemia. Transaminase levels improved in 16 (64%) and bilirubin levels in 15 (60%) patients receiving ursodeoxycholic acid. Catheter thrombosis was seen in 4.5% of the episodes. The targeted energy could be given more efficiently via central catheters rather than peripheral venous accesses. Patients' bodyweights increased in 39.1% of the episodes.
Conclusions:
Close monitoring of electrolyte levels, especially in the first 3 days, is crucial to prevent complications of parenteral nutrition. When individualized PN preparations are used for metabolically unstable patients, it can be easier to maintain the blood glucose, lipids, and electrolyte levels within the normal range.
More Related Videos
Related Concept Videos
01:27Parentral Nutrition: Centeral and Peripheral Parental Nutrition
PN can be administered through two primary routes:
1. Central Parenteral Nutrition (CPN):
CPN involves delivering a high concentration of nutrients through a large vein. This is typically achieved using a Peripherally Inserted Central Catheter (PICC) or,...
01:15Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
01:29Endocarditis IV: Nursing Management
01:30Pneumonia III: Complications and Assessment
01:26Enteral Nutrition I: Orogastric and Nasogastric Feeding
Orogastric (OG) and nasogastric (NG) feeding are two standard methods used for enteral nutrition. Enteral nutrition is often preferred over...
01:25Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications