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PN delivered <10 days?

PARENTERAL NUTRITION (PN) GUIDELINES. www.criticalcarenutrition.com. PN delivered <10 days?. Yes. No. 1) Provide hypocaloric PN  . 2) Withhold IV lipids high In soybean oil  . (unless pt malnourished). 1) Provide required energy level. 2) Provide IV lipids.

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PN delivered <10 days?

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  1. PARENTERAL NUTRITION (PN) GUIDELINES. www.criticalcarenutrition.com PN delivered <10 days? Yes No 1) Provide hypocaloric PN. 2) Withhold IV lipids high In soybean oil . (unless pt malnourished) 1) Provide required energy level. 2) Provide IV lipids. All strategies to maximize EN ruled out? (i.e. acceptable gastric residual volume threshold 250 ml; prokinetics; small bowel feeding). No Yes Implement strategies; increase EN to goal rate as per ‘Enteral Nutrition Feeding Guideline’. Provide EN at 10-25 ml/hr if possible. Provide IV glutamine. If IV N/A consider enteral glutamine (0.25 gm/kg/day - 0.5 gm/kg/day mixed in 50 ml saline; delivered in divided doses). In surgical critically ill patients intensive insulin therapy to tightly control blood sugars between 4.4 - 6.1 should be considered. Evidence-based recommendation. All other recommendations opinion-based. Formatted by: J. Greenwood, RD (Vancouver General Hospital) in collaboration with the CCCCPGC (21/7/03).

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