Protocol and guideline for care of a child or young person receiving parenteral nutrition (PN)

Paediatric guidelines (in development)
NHS Lothian

Objectives

The purpose of this document is to ensure all nursing, medical and pharmacy staff working within Royal Hospital for Children and Young People (RHCYP), or other NHS Lothian sites, are aware of the processes, protocols and potential complications for children and young people who require parenteral nutrition (PN).

Scope

This protocol and guideline applies to all nursing, medical and pharmacy staff caring for children and young people requiring PN within RHCYP.

Audience

NHS Lothian paediatric medical and trained nursing staff within the Royal Hospital for Children and Young People

Roles and Responsibilities

It is the responsibility of all staff involved in the care of a patient receiving PN to have read and understood this protocol. If any member of staff has any concerns, they should address these with a trained member of staff before proceeding.

Editorial Information

Last reviewed: 07/09/2024

Author(s): Nutrition Nurse Specialist, Consultant Paediatric Gastroenterologist, Senior Paediatric Pharmacist, Senior PGHAN Dietitian, Clinical Risk and Education Facilitator.

Approved By: P&N D&T

Reviewer name(s): Executive Lead: Catherine Paxton, Nutrition Nurse Specialist.

Related resources
  • Loveday H.P, Wilson J.A, Pratt R, Golsorkhi M, Tingle A, Bak A, Browne J, Prieto J, Wilcox M (2014)
    Epic3: National Evidence - Based Guidelines for Preventing Healthcare - Associated Infection in NHS
    Hospitals in England. The Journal of Hospital Infection, Vol 86, Supplement 1, pS1-S70, January 2014
  • ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition (2018). Clinical Nutrition
    37(6).
  • Home Parenteral Nutrition Good Practice Guidance for NHS Boards (2012)
    http://www.knowledge.scot.nhs.uk/child-services/communities-of-practice/home-parenteral-nutrition.aspx
  • Royal College of Nursing (2017) Standards for Infusion Therapy. 4th Edition. RCN. London.
  • Heyman MB et al. The fat overload syndrome: report of a case and review of the literature. Am J Dis
    Child 1981; 135: 628-30
  • Campbell AN et al. Bleeding disorders from the “fat overload” syndromeJPEN 1984; 8: 447-9
  • Mirtallo JM, Dasta JF, Kleinschmidt KC & Varon J (2010) State of the art review: Intravenous Fat
    Emulsions: Current applications, safety proflie and clinical implications. The Annals of
    Pharmacotherapy. 44, 688-700
  • Gura KM & Puder M (2010) Rapid infusion of Fish Oil-Based Emulsion in Infants Does Not Appear to
    be Associated with Fat Overload Syndrome. Nutrition in Clinical Practice. 25(4), 399-402
  • Hojsak I & Kolacek S (2014) Fat Overload Syndrome After the Rapid Infusion of SMOFlipid Emulsion.
    Journal of Parenteral and Enteral Nutrition. 38(1), 119-121
  • Handrup MH, Moller JK & Schroder H (2013) Central Venous Catheters and Catheter Locks in Children
    with Cancer: A Prospective Randomized Trail of Taurolidine Versus Heparin. Pediatric Blood Cancer.
    60(8), 1292-1298.
  • Bradshaw JH & Puntis JWL (2008) Taurolidine and Catheter-related Bloodstream Infection: A
    Systematic Review of the Literature. Journal of Pediatric Gastroenterology and Nutrition. 47(2), 179-
    186.
  • Khasawneh W & Hani SB (2018) Intravenous Lipid Emulsion Overdose in Infancy: A Case Report and
    Overview of Opportunities, Challenges and Prevention. Drug Saf- Case Rep 5:13.