Intravenous Nutrition

 

Reviewed by Malcolm Battin & Barbara Cormack
July 2008
Clinical Guidelines Back Newborn Services Home Page
Indications Standard Solutions Examples
Individualised Solutions References Other Documents

Indications for Intravenous Nutrition

Standard Intravenous Nutrition Solutions

 

Starter
For use from Days 0-2
Must be given via UVC, longline, or surgical CVL

P100
For use Day 2 and beyond
Can be given from birth if necessary

Composition Usual intake at
30 ml/kg/day
Composition Usual intake at
90 ml/kg/day
Protein 67.9 g/L 2.0 g/kg/day 42.0 g/L 3.8 g/kg/day
Nitrogen 10.9 g/L 0.3 g/kg/day 6.70 g/L 0.6 g/kg/day
Amino acid 70.0 g/L 2.1 g/kg 43.0 g/L 3.9 g/kg
Glucose 150 g/L 4.5 g/kg/day 100 g/L 9.0 g/kg/day
Sodium 3.5 mmol/L 0.1 mmol/kg/day 55 mmol/L 5 mmol/kg/day
Potassium 0 mmol/L 0 mmol/kg/day 28.0 mmol/L 2.5 mmol/kg/day
Chloride 0 mmol/L 0 mmol/kg/day 28.0 mmol/L 2.5 mmol/kg/day
Gluconate 32.2 mmol/L 1.0 mmol/kg/day 34.0 mmol/L 3.1 mmol/kg/day
Acetate 67.9 mmol/L 2.0 mmol/kg/day 56.71 mmol/L 5.1 mmol/kg/day
Calcium 16.10 mmol/L 0.5 mmol/kg/day 17.02 mmol/L 1.5 mmol/kg/day
Phosphate 0 mmol/L 0 mmol/kg/day 19.0 mmol/L 1.7 mmol/kg/day
Magnesium Nil Nil 2.8 mmol/L 0.25 mmol/kg/day
Trace elements 0 ml/L 0 ml/kg/day 11 ml/L 1 ml/kg/day
Zinc 5 mg/L 150 mcg/kg/day Included in trace elements
Heparin 500 U/L 15 U/kg/day 500 U/L 45 U/kg/day
Energy 782 kcal/L 23 kcal/kg/day 497 kcal/L 45 kcal/kg/day
Osmolality 1398mOsm/kg 1067 mOsm/kg

Examples

Fluid Intake (ml/kg/day) Intake (ml/day) Intake (ml/hour)
Total fluid intake 75ml/kg/day 71.3ml 3.0ml/hour
UAC (0.45% NaCl) 13ml/kg/day 12.0ml 0.5ml/hour
Oral feeds Counted as "extra" (6ml 1ml every 4 hours)
IVN (Starter) 30ml/kg/day 28.8ml 1.2ml/hour
Intralipid 20% (2g/kg/day) 10ml/kg/day 9.6ml 0.4ml/hour
10% Dextrose 23ml/kg/day 21.6ml 0.9ml/hour
Fluid Intake (ml/kg/day) Intake (ml/day) Intake (ml/hour)
Total fluid intake 75ml/kg/day 71.3ml 3.0ml/hour
UAC (0.45% NaCl) 13ml/kg/day 12.0ml 0.5ml/hour
Oral feeds Counted as extra (6ml 1ml every 4 hours)
Dopamine (5mcg/kg/min) 13ml/kg/day 12.0ml 0.5ml/hour
IVN (Starter) 30ml/kg/day 28.8ml 1.2ml/hour
Intralipid 20% (2g/kg/day) 10ml/kg/day 9.6ml 0.4ml/hour
10% Dextrose 10ml/kg/day 9.6ml 0.4ml/hour
Fluid Intake (ml/kg/day) Intake (ml/day) Intake (ml/hour)
Total fluid intake 180ml/kg/day 172.8ml 7.2ml/hour
UAC (0.9% NaCl) 13ml/kg/day 12.0ml 0.5ml/hour
Oral feeds 25ml/kg/day 24.0ml 2ml Q2H
IVN (P100) 90ml/kg/day 86.4ml 3.6ml/hour
Intralipid 20% (3g/kg/day) 15ml/kg/day 14.4ml 0.6ml/hour
10% Dextrose 38ml/kg/day 36.0ml 1.5ml/hour

Individualised Amino Acid Solutions

References

1 Consensus Recommendations; Summary of Reasonable Nutrient Intakes for Preterm Infants In: Tsang R, Uauy R, Koletzko B, Zlotkin S. Nutrition of the Preterm Infant. Scientific Basis and Practical Guidelines. Cincinnati, Ohio: Digital Publishing Inc; 2005: 415-6.
2 Guidelines on Paediatric Parenteral Nutrition of the ESPGHAN and the ESPEN, J Pediatr Gastroenterol Nutr 2005;41 Suppl 2:S1-87.
3 Yeung MY, Smyth JP, Maheshwari R, Shah S. Evaluation of standardized versus individualized total parenteral nutrition regime for neonates less than 33 weeks gestation. J Paediatr Child Health 2003;39:613-7.