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Enhancing Parenteral Nutrition Therapy for the NeonateNeonatal Nutrition Team, Section of Neonatology, Pharmacy Department, Columbus Children's Hospital, Ohio State University, Columbus, Ohio Correspondence: Correspondence: Christina J. Valentine, MD, MS, RD, Pediatrics/Neonatology, Columbus Children's Hospital, Ohio State University, 700 Children's Drive, Columbus, OH 43205. Electronic mail may be sent to valentine{at}pediatrics.ohio-state.edu.
The neonate receiving parenteral nutrition (PN) therapy requires a
physiologically appropriate solution in quantity and quality given according
to a timely, cost-effective strategy. Maintaining tissue integrity,
metabolism, and growth in a neonate is challenging. To support infant growth
and influence subsequent development requires critical timing for nutrition
assessment and intervention. Providing amino acids to neonates has been shown
to improve nitrogen balance, glucose metabolism, and amino acid profiles. In
contrast, supplying the lipid emulsions (currently available in the United
States) to provide essential fatty acids is not the optimal composition to
help attenuate inflammation. Recent investigations with an
Nutrition in Clinical Practice, Vol. 22, No. 2,
183-193 (2007) This article has been cited by other articles:
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-3 fish oil
IV emulsion are promising, but there is need for further research and
development. Complications from PN, however, remain problematic and include
infection, hepatic dysfunction, and cholestasis. These complications in the
neonate can affect morbidity and mortality, thus emphasizing the preference to
provide early enteral feedings, as well as medication therapy to improve liver
health and outcome. Potential strategies aimed at enhancing PN therapy in the
neonate are highlighted in this review, and a summary of guidelines for
practical management is included. 
