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Clinical Nutrition Guideline for Parenteral Nutrition in Critical Care

Follow these guidelines for Parenteral Nutrition in critically ill patients, focusing on hypocaloric PN, IV lipids, energy levels, IV glutamine, and managing hyperglycemia to ensure optimal nutrition support.

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Clinical Nutrition Guideline for Parenteral Nutrition in Critical Care

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  1. ICU GUIDELINE: PARENTERAL NUTRITION (PN) www.criticalcarenutrition.com Yes PN to be delivered <10 days and patient well-nourished? No 1) Provide hypocaloric PN. 2) Withhold IV lipids. 1) Provide required energy level. 2) Provide IV lipids. All strategies to maximize EN implemented? (e.g. protocol outlining acceptable gastric residual volume of 250 ml; prokinetic(s)* provided; small bowel feeding tube placed). Yes No 1) Provide low dose EN*.2) Provide IV glutamine. If IV N/A considerenteral glutamine (0.25 gm/kg/day - 0.5 gm/kg/day mixed in 50 ml saline; delivered in divided doses). 1) Implement strategies as noted above.2) Increase EN to goal rate as tolerated. In critically ill patients hyperglycemia should beavoided (blood sugar > 10 mmol/L). Target blood glucose 8.0 mmol/L (7.0 – 9.0 mmol/L) * Unless contraindicated  Evidence-based recommendation; all other information opinion-based. Formatted by: J. Greenwood, RD. for CCN. Update 7/4/2010

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