Safe and efficient practice of parenteral nutrition in neonates and children aged 0-18 years - The role of licensed multi-chamber bags.

Parenteral nutrition (PN) is recognized as a complex high-risk therapy. Its practice is highly variable and frequently suboptimal in pediatric patients. Optimizing care requires evidence, consensus-based guidelines, audits of practice, and standardized strategies. Several pediatric scientific organizations, expert panels, and authorities have recently recommended that standardized PN should generally be used over individualized PN in the majority of pediatric patients including very low birth weight premature infants. In addition, PN admixtures produced and validated by a suitably qualified institution are recommended over locally produced PN. Licensed multi chamber bags are standardized PN bags that comply with Good Manufacturing Practice and high-quality standards for the finished product in the frame of their full manufacturing license. The purpose of this article is to review the practical aspects of PN and the evidence for using such multi-chamber bags in pediatric patients. It highlights the safety characteristics and the limitations of the different PN practices and provides some guidance for ensuring safe and efficient therapy in pediatric patients.

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Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.

Déclaration de conflit d'intérêts

Conflict of Interest VC, MD, NH, JR, MSDP, ST, FV, DW, and CvdA have received honoraria from Baxter Healthcare Corporation for symposium participation or scientific education activity. HA has received honoraria from Baxter Healthcare Corporation and Fresenius Kabi for symposium participation or scientific education activity. MP has received honoraria from Baxter Healthcare Corporation, Fresenius Kabi, and B. Braun for symposium participation or education scientific activity. MD, VC and MT have received investigator-initiated research grants from the Baxter Healthcare Corporation (money paid to their institutions). TS is an employee of Baxter Healthcare Corporation. PL and LO have no conflicts of interest to declare.