Parenteral Nutrition

Updated: July 1, 2024

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Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

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Hormone Therapy

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Hyperthermia

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Stem Cell Transplant

Targeted Therapy

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Medication

 

trace elements 


Indicated for Parenteral nutrition
Bodyweight >50 kg:
Each ml of dose provides zinc 3 mg, manganese 55 mcg, copper 0.3 mg, and selenium 60 mcg
1 ml every day added to the Parenteral nutrition
It is not suggested for individuals who might require a low dose of 1 or more individual trace elements



soyabean oil 

Use as per physicians advised



amino acids and electrolytes in dextrose with calcium 

The patient's body weight, nutritional and hydration needs, clinical state (ability to metabolize the amino acids and dextrose), and additional energy provided orally or enterally all play a role in determining the appropriate Clinimix E dosage.
There are two-port and three-port container configurations for CLINIMIX E available.
A three-port container has one port for medication, one port for additives, and one port for the outlet.
One power port and one medicine port make up the two port containers.



chromic chloride 

Chromic Chloride Injection 4 mcg/mL contains 4 mcg chromium/mL and administered intravenously after the dilution. The suggested additive dose is 10-15 mcg chromium daily



zinc chloride 

Requirement as maintenance
Intravenous
Note- stated in terms of zinc elements
Acute metabolic states
Administer 4.5-6 mg daily
Metabolically stable
Administer 2.5-5 mg daily
Consistent with loss of fluid from small bowel
Administer 12.2 mg TPN zinc/l
Or Administer 17.1 mg zinc/kg
(supplemented with 1000 mL Intravenous fluids)



n-acetyltyrosine 

It is indicated as a supplement in TPN
The usual recommended dosage is 700 mg upto 1000 mg via oral administration



Dose Adjustments

Limited data is available

docosahexaenoic acid/eicospentaenoic acid 

It is a combination drug which used in the treatment of nutritional deficiencies



amino acid mixture d / calcium chloride dihydrate / glucose monohydrate / glycine / magnesium chloride hexahydrate / olive oil / potassium chloride / sodium acetate trihydrate / sodium glycerophosphate pentahydrate / soya-bean oil 

Indicated for Total parenteral nutrition
The daily maximum dosage is 33 ml emulsion per kg of body weight
So, if someone weighs 70 kg, their daily limit is 2310 ml (33 ml x 70 kg)
The recommended dose ranges from 25 to 40 kCal of emulsion per kg of body weight daily
That's the typical energy requirement for most patients on this therapy



 

trace elements 


Indicated for Parenteral nutrition
Tralement:
Bodyweight 10-19 kg: 0.2 ml, which provides zinc 600 mcg, manganese 11 mcg, copper 60 mcg, and selenium 12 mcg every day
Bodyweight 20-29 kg: 0.4 ml, which provides zinc 1200 mcg, manganese 22 mcg, copper 120 mcg, and selenium 24 mcg every day
Bodyweight 30-39 kg: 0.6 ml, which provides zinc 1800 mcg, manganese 33 mcg, copper 180 mcg, and selenium 36 mcg every day
Bodyweight 40-49 kg: 0.8 ml, which provides zinc 2400 mcg, manganese 44 mcg, copper 240 mcg, and selenium 48 mcg every day
Dosage of the zinc (in heavier individuals in certain weight bands), copper/selenium
Extra supplementation using single trace element items might be needed for these individuals
Bodyweight >50 kg:
Each ml of dose provides zinc 3 mg, manganese 55 mcg, copper 0.3 mg, and selenium 60 mcg
1 ml every day added to the Parenteral nutrition
It is not suggested for individuals who might require a low dose of 1 or more individual trace elements
Body weight <10 kg:
Safety and efficacy not established
Multrys
Bodyweight 0.6-0.8 kg: 0.2 ml, which provides zinc 200 mcg, manganese 0.6 mcg, copper 12 mcg, and selenium 1.2 mcg every day
Bodyweight 0.9-1.1 kg: 0.3 ml, which provides zinc 300 mcg, manganese 0.9 mcg, copper 18 mcg, and selenium 1.8 mcg every day
Bodyweight 1.2-1.4 kg: 0.4 ml, which provides zinc 400 mcg, manganese 1.2 mcg, copper 24 mcg, and selenium 2.4 mcg every day
Bodyweight 1.5-1.7 kg: 0.5 ml, which provides zinc 500 mcg, manganese 1.5 mcg, copper 30 mcg, and selenium 3 mcg every day
Bodyweight 1.8-2 kg: 0.6 ml, which provides zinc 600 mcg, manganese 1.8 mcg, copper 36 mcg, and selenium 3.6 mcg every day
Bodyweight 2.1-2.3 kg: 0.7 ml, which provides zinc 700 mcg, manganese 2.1 mcg, copper 42 mcg, and selenium 4.2 mcg every day
Bodyweight 2.4-2.6 kg: 0.8 ml, which provides zinc 800 mcg, manganese 2.4 mcg, copper 48 mcg, and selenium 4.8 mcg every day
Bodyweight 2.7-2.9 kg: 0.9 ml, which provides zinc 900 mcg, manganese 2.7 mcg, copper 54 mcg, and selenium 5.4 mcg every day
Bodyweight 3-9.9 kg: 1 ml, which provides zinc 1000 mcg, manganese 3 mcg, copper 60 mcg, and selenium 6 mcg every day
Extra trace elements supplementation:
Body weight <3 kg: It is not recommended to have a daily dose of zinc; add zinc sulfate to reach a total daily dose (TDD) of 400 mcg/kg every day
Body weight 0.4 kg-9.9 kg: It is not recommended to have a daily dose of copper or selenium
Selenium: total daily dose of 2 mcg/kg every day
Copper: total daily dose of 20 mcg/kg every day



soyabean oil 

For 13 to 18 years old:
Use as per physicians advised



chromic chloride 

Chromic Chloride Injection 4 mcg/mL contains 4 mcg chromium/mL and administered intravenously after the dilution. The suggested additive dose is 0.14-0.20 mcg/kg daily



zinc chloride 

Requirement as maintenance
Dosing based on age
Infants aged less than three months
Administer 250 mcg/kg intravenously daily as parenteral nutrition solution supplemented with elemental zinc
Infants aged three months or more
Administer 50 mcg/kg intravenously daily as parenteral nutrition solution supplemented with elemental zinc
Children
Administer 50 mcg/kg intravenously daily as parenteral nutrition solution supplemented with elemental zinc
Administration of 5,000 mcg in a day as maximum day dose Weight based dosing
Infants less than 10 kg
Administer 50-250 mcg/kg daily as parenteral nutrition solution supplemented with elemental zinc
Children weigh 10-40 kg
Administer 50-125 mcg/kg daily as as parenteral nutrition solution supplemented with elemental zinc
Administration of 5,000 mcg in a day as maximum day dose
Adolescents & children weight more than 40 kg
Administer 2000-5000 mcg daily as parenteral nutrition solution supplemented with elemental zinc



docosahexaenoic acid/eicospentaenoic acid 

For 13 to 18 years old:
It is a combination drug which used in the treatment of nutritional deficiencies



 

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Parenteral Nutrition

Updated : July 1, 2024

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