Initiating PN

Exercise caution when initiating PN to avoid hyperglycemia, and fluid and electrolyte abnormalities. Once the goal daily volume is determined, infuse the PN admixture first over 24 hours. For safety, initiate PN at a lower infusion rate (e.g., approximately 50% of goal for anywhere from approximately 12 to 24 hours) on day 1 with no more than 150 to 200 g of dextrose per day (or a maximum dextrose infusion rate of approximately 2 mg/kg/min). Then increase PN up to goal over the following approximately 12

to 24 hours, provided that glycemic control is maintained and the patient does not experience any significant fluid or electrolyte abnormalities. Monitor electrolytes daily and correct as needed. Patients with severe malnutrition should be advanced to goal more slowly and cautiously, and they should be monitored for refeeding syndrome (see Complications of PN below).

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