Nutritional management in pediatric patients is often considered to be complex and difficult. We review the basic rationale and principles of IV nutrition support in pediatric patients. The unique differences between children and adults are outlined. The nutritional support solution is then divided into the distinct sections of energy, protein, volume, electrolytes, minerals and vitamins. Each of these parts is considered separately to allow understanding in a sequential fashion. Different routes of intravenous access are also discussed to include placement, maintenance, treatment of infections and management of catheter thrombosis.
Get full access to this article
View all access options for this article.
References
1.
Groner JI, Brown MF, Stallings VA, et al. REE in children following major operative procedures. J Pediatr Surg1989;24:825-8.
2.
Hildreth M., Herndon DN, Desai MH, et al. Current treatment reduces calories required to maintain weight in pediatric burn patients. J Burn Care Rehab1990;11:405-9.
3.
Shanbhogue RLK , Lloyd DAAbsence of hypermetabolism after operation in the newborn infant. JPEN1992 ;16:333-6.
4.
Bell SJ, Wyatt J.Nutrition guidelines for burned patients. J Am Diet Assoc1986;86:648-53.
5.
Kien CL, Young VR, Wohrbaugh DK, et al. Increased rates of full body protein synthesis and breakdown in children recovering from burns. Ann Surg1978;187:383-91.
6.
Doherty JF, Golden HN, Raynes JG, et al. Acute-phase protein is impaired in severely malnourished children . Clin Sci1993;84:169-75.
7.
Cerra FB, Mazuski JE, Chute E., et al. Branched chain metabolic support: a prospective, randomized, double-blind trial in surgical stress. Ann Surg1984;286-91.
8.
Cerra FB, Cheung NK,Fischer JE, et al. Disease-specific amino acid infusion (F080) in hepatic encephalopathy: a prospective, randomized, double-blind, controlled trial. JPEN1985;9:288-95.
9.
Naylor CD, O'Rourke K., Detsky AS, et al. Parenteral nutrition with branched-chain amino acids in hepatic encephalopathy: a meta-analysis. Gastroenterology1989;97:1033-42.
10.
Marchesini G., Dioguardi FS, Bianchi GP, et al. Long-term oral branched-chain amino acid treatment in chronic hepatic encephalopathy: a randomized double-blind casein-controlled trial. J Hepatol1990;11:1-10.
11.
Fischer JEBranched-chain-enriched amino acid solutions in patients with liver failure: an early example of nutritional pharmacology. JPEN1990;14 (Suppl):249S-56S.
12.
Souba WW, Long JM, Dudrick SJEnergy intake and stress as determinant of nitrogen excretion in rats . Surg Forum1978;29:776-7.
13.
Jeevanandam M., Leland D., Shamos RF, et al. Glucose infusion improves endogenous protein synthesis efficiency in multiple trauma victims . Metabolism1991;40:1199-206.
14.
Greigh PD, Elwyn DH, Askanazi J., et al. Parenteral nutrition in septic patients: effective increasing nitrogen intake. Am J Clin Nutr1987;46:1040-7.
15.
Friedman Z. , Danon A., Stahlman MT, et al. Rapid onset of essential fatty acid deficiency in the newborn. Pediatrics1976 ;58:640-9.
16.
Heird WCLipid metabolism in parenteral nutrition. In: Fomon SJ, Heird WC, eds. Energy and protein needs in during infancy. San Diego: Academic Press, 1986;215-29.
17.
Pereira GR, Fox WW, Stanley CA, et al. Decreased oxygenation and hyperlipemia during intravenous fat infusions in premature infants. Pediatrics1980;66:26-30.
18.
Levene MI, Wigglesworth JS, Desai R.Pulmonary fat accumulation after intralipid infusion in the preterm infant . Lancet1980;2:815-8.
19.
Friedman Z. , Marks KH, Maisels MJ, et al. Effect of parenteral fat emulsion on the pulmonary and reticuloendothelial systems in the newborn infant. Pediatrics1978;61:694-8.
20.
Skipper A, ed. Dietitians handbook of enteral and parenteral nutrition. Rockville, MD: Aspen Publishers, 1989.
21.
Behrman RENelson's textbook of pediatrics. Philadelphia: WB Saunders, 1982.
22.
Committee on Dietary Allowances.Recommended dietary allowances, 10th ed. Washington, DC: National Academy of Science, 1989.
23.
Arakawa T., Tamura T., Igarashi Y., et al. Zinc deficiency in two infants during total parenteral alimentation for diarrhea. Am J Clin Nutr1976;29:197-204.
24.
Sanstead JJ , Lanier VC, Shephard GH, et al. Zinc and wound healing: effects of zinc deficiency and zinc supplementation. Am J Clin Nutr1970;23:514-9.
25.
Luterman A. , Adams M., Curreri PWNutritional management of the burn patient . Crit Care Q1984;7:34-42.
26.
Sutherland AB, Batchelor ADR.Nitrogen balance in burned children. Ann NY Acad Sci1968;150:700-19.
27.
Ulz L., Peterson FB, Ford R., et al. A prospective study of complications in Hickman right-atrial catheters in marrow transplant patients. JPEN1990;14:27-30.
28.
Glynn MFX , Phil D., Path MRC , et al. Techniques, materials, and devices: therapy for thrombotic occlusion of long-term intravenous alimentation catheters . JPEN1980;4:387-90.
29.
Bagnall HA, Gomperts E., Atkinson JBContinuous infusion of low-dose urokinase in the treatment of central venous catheter thrombosis in infants and children. Pediatrics1989;83:963-6.
