Parenteral nutrition (PN) remains a life-saving intervention for patients where achieving oral or enteral nutrition (EN) is either not possible or not acceptable. The essential elements of PN are carbohydrates, lipids, amino acids, vitamins, trace elements, electrolytes, and water. It is advisable to give PN via a central line because of its hypertonicity. However, peripheral PN (with lower nutrient content and larger volume) is possible via an appropriate non-central line.

There are also options for the compounding process, including hospital pharmacy compounded bags and commercial multi-chamber bags. PN is an expensive therapy and has shown associations with complications. Metabolic complications related to macro and micronutrient disturbances, like hyperglycemia, hypertriglyceridemia, and electrolyte imbalance, may be encountered during PN therapy, as well as infectious complications, which are mostly related to venous access. Long-term complications, such as hepatobiliary and bone disease, are linked with longer PN therapy and home PN. The optimal monitoring and early management of imbalances will help prevent and mitigate potential complications. PN should be given to malnourished or high-risk patients with malnutrition where full EN is impossible. It is crucial to consider certain factors while providing PN, like the timing of initiation, clinical status, and risk of complications.

Berlana D. Parenteral Nutrition Overview. Nutrients. 2022; 14(21):4480. https://doi.org/10.3390/nu14214480