Parenteral nutrition: an overview of current practice

Nutritional support should always be provided via the gastrointestinal tract if possible, but parenteral nutrition, i.e. infusion of nutrients directly into the venous circulation, can be a safe and effective method of nutritional support when used in carefully selected patients and monitored appropriately. A multidisciplinary team approach to patient selection, assessment and monitoring is recommended. Access for parenteral feeding is traditionally via a central vein, but the peripheral route can be used for short-term feeding and should be considered for the majority of patients. Nutritional requirements should be assessed on an individual basis and a feeding regimen designed using standard formulations where possible. The transition back onto oral or enteral nutrition should be closely supervised by a dietitian. Parenteral feeding can be provided to the community if appropriate, but thorough training, monitoring and support are essential.