Long term parenteral nutrition

Intestinal failure (I.F) is a term applied when intestinal function is insufficient to allow adequate absorption of fluid, electrolytes, or nutrients required for normal growth and survival. The development of parenteral nutrition (P.N) as a treatment modality has greatly improved the outcome for children with I.F and has contributed to improved outcomes in neonates and children from intensive care settings. Home parenteral nutrition (H.P.N) is central to the care of patients when I.F is expected to last for more than 3–6 months. Normal growth and long term survival is now expected for the majority of patients on H.P.N when only 10 years ago, the prognosis for survival was poor. Adolescents with I.F now successfully transfer to adult services, many of which will have been dependent on P.N since early infancy. This article reviews the current indications for P.N and the recent advances in P.N that have contributed to better outcomes.