ABSTRACT
Parenteral nutrition (PN) for the pediatric population has now been available for about 40 years [1]. It is often a life-saving means of nutrition support and serves as a bridge until enteral feedings can be initiated and advanced. Over the years there have been many modi—cations in the components and method of delivery in the quest to meet the needs of the patients and provide a safe and ef—cacious product. Pediatric patients with intestinal failure are particularly dependent on PN and in fact this dependence is incorporated into common case de—nitions of intestinal failure. (Although some authors refer to parenteral nutrition as “total parenteral nutrition” or TPN, we prefer “PN” to avoid the implication that PN is a complete source of human nutrition and/or that it meets all nutrient requirements in humans.)
For the pediatric population there are many conditions for which PN is indicated. In general, it is used for patients who cannot be enterally fed. The clinical conditions leading to this situation can often be divided into medical and surgical conditions (Table 10.1). The medical indications include: chronic diarrhea, acute «are in in«ammatory bowel disease, gastrointestinal motility disorders, and prematurity. Typical surgical conditions include congenital anomalies of the gastrointestinal tract that require surgical repair such as gastroschisis and intestinal atresias. All of these conditions, whether medical or surgical based, require a period where enteral feeding could pose a greater risk and/or would not be tolerated.
