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Nutrition in Clinical Practice
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Impact of Customized Parenteral Nutrition in a Pediatric Hospital

Nicolas Stettler, MD, MSCE

Division of Gastroenterology and Nutrition

Timothy A. Sentongo, MD

Department of Anesthesia and Critical Care Medicine, The Children's Hospital of Philadelphia, Pennsylvania

Mimi Carroll

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Gregory J. Schears, MD

Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania

Maria R. Mascarenhas, MD

Division of Gastroenterology, Hepatology, and Nutrition, Children's Memorial Medical Center, Northwestern University Medical School, Chicago, Illinois

In pediatric hospitals, several factors interfere with the delivery of parenteral nutrition (PN). The purpose of this study was to assess the impact of a customized system of PN ordering on PN delivery, using a retrospective chart review before (n = 40) and after (n = 43) implementation of the system. No difference was observed in the proportions of children who did not receive the ordered amount of dextrose and amino acids (30% versus 23%, p = .49). Before customization, the subjects were more likely to receive intralipids (42% versus 19%, p = .02), and micronutrients (67% versus 9%, p < .0001) out of range. These results remained unchanged after adjustment for age, hospital unit, other fluids, and presence of a central line. Our findings highlight the discrepancy between ordered and received PN in pediatric patients. Customized PN ordering was associated with improved delivery of intralipids and micronutrients.

Nutrition in Clinical Practice, Vol. 16, No. 6, 345-348 (2001)
DOI: 10.1177/088453360101600607
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