Parenteral Nutrition in Preterm Infants
Summary of Recommendations
- ASPEN Position Paper: Recommendations for Changes in Commercially Available Parenteral Multivitamin and Multi–Trace Element Products
- ESPGHAN/ESPEN/ESPR/CSPEN Guidelines: Pediatric Parenteral Nutrition: Iron and Trace Minerals
- ASPEN Clinical Guidelines: Parenteral Nutrition Ordering, Order Review, Compounding, Labeling, and Dispensing
Recommendation Grading
Abbreviations
- AA: Intravenous Amino Acids
- BSID: Bayley Scales Of Infant Development
- ILE: Injectable Lipid Emulsion
- NEC: Necrotizing Enterocolitis
- PN: Parenteral Nutrition
- PNALD: PN-associated Liver Disease
- ROP: Retinopathy Of Prematurity
Disclaimer
Overview
Title
Parenteral Nutrition in Preterm Infants
Authoring Organization
American Society for Parenteral and Enteral Nutrition
Publication Month/Year
August 23, 2023
Last Updated Month/Year
April 1, 2024
Document Type
Guideline
Country of Publication
US
Document Objectives
The purpose of this guideline is to systematically evaluate the quality of relevant literature and provide recommendations on key clinical questions pertaining to the clinical practice of providing PN in preterm infants. The focus of this guideline is on preterm infants born without congenital diseases requiring surgery and does not address preterm infants who have been diagnosed with PN-associated liver disease (PNALD). This guideline's target population of preterm infants is expected to advance to full enteral nutrition without difficulty except in the event of necrotizing enterocolitis (NEC), an unpredictable complication associated with prematurity. The questions in this guideline address multiple aspects of PN, including the timing of PN initiation, nutrient dosing, and lipid injectable emulsion (ILE) composition. The a priori focus of the guideline was on the nutrients in PN; this guideline does not address aspects such as PN compounding and/or logistics of administration. This guideline serves as a foundation for future updates and systematic evaluation of additional relevant questions.
Target Patient Population
Infants born preterm (birth prior to 37 weeks of gestation) without congenital diseases requiring surgery
Target Provider Population
Providers involved in prescribing PN to preterm infants. These include: neonatal physicians, nurse practitioners, physician assistants, nurses, dietitians, pharmacists, and interdisciplinary nutrition support teams in neonatal intensive care units
Inclusion Criteria
Male, Female, Infant
Health Care Settings
Hospital, Outpatient
Intended Users
Dietician nutritionist, nurse, nurse midwife, nurse practitioner, health systems pharmacist, physician, physician assistant
Scope
Treatment, Management
Diseases/Conditions (MeSH)
D007224 - Infant Care, D007225 - Infant Food, D007228 - Infant Nutrition Disorders, D007223 - Infant, D010288 - Parenteral Nutrition
Keywords
parenteral nutrition, infant nutrition, Preterm Infants
Source Citation
Robinson, DT, Calkins, KL, Chen, Y, et al. Guidelines for parenteral nutrition in preterm infants: the American Society for Parenteral and Enteral Nutrition. J Parenter Enteral Nutr. 2023; 47: 830-858. doi:10.1002/jpen.2550