[Application of enteral and "individual" parenteral nutrition therapies in pediatric patients]

Abstract

In long-standing stress situation, in malabsorption syndromes we cannot provide the adequate protein and energy intake with enteral nutrition, so we often have to add complementary parenteral feeding. Using combined enteral and "individualised" parenteral nutrition the quality of life improves, the time of hospital stay decreases. The parenteral nutrition of neonates and infants implies a great challenge for health care supplier; there is no available "All-in-One" mixture infusion below 2 years of age. We developed a new chart for parenteral nutrition, which can be modified easily according to the patient's age, body weight, need. This chart was introduced to the "Guidelines of the Infant and Pediatric Board" in 2003 and accepted by the Health Ministry in 2006. The Central Pharmacy of the Semmelweis University prepares the "individualised" parenteral mixture in laminar air-flow box, in aseptic condition. Further advantage of the Infusion Mixture, that 4-day portion can be prepared. We review the usefulness and the development of combined enteral and "individualised" parenteral nutrition. Altogether we had 30 patients needing total parenteral nutrition (TPN) in the last 5 years: 46% short bowel syndrome, 18% oesophageal disorders, 15% oncology patients, 21 % septicaemia and other disorders. Beside the "individualised" parenteral nutrition the use of enteral formulas increased, too. Our goal is the optimal combination of parenteral and enteral nutrition in order to diminish the hospital stay and to improve the quality of life of our patients.