 |
If obtaining goal feeds will take more than four days, the neonate
will probably require parenteral nutrition |
|
Parenteral nutrition should be started as soon as electrolytes are
stable and urine output is established (less than 72 hours of life) |
|
Consolidate fluids as much as possible to maximize parenteral nutrition
volume |
|
Nutrients should be advanced slowly each day for tolerance |
|
Providing a mixed fuel system is best for energy utilization:
| Protein |
8-12% of cals |
| Carbohydrate |
40-55% of cals |
| Fat |
35-50% of cals |
|
|
|
Carbohydrates and proteins are combined in the same bag of solution
along with vitamins, minerals, electrolytes, trace elements, and other
additives. |
|
Fat is given separately and is piggybacked by a Y-connector |
|
If supplementing inadequate feeds with parenteral nutrition, the parenteral
component can be decreased with feeds tolerated at 50% goal and can be
discontinued when feeds are at 75% of goal. At that time formula
will need to be fortified to 22 kcal/ounce. |
