Plan

Admit to the surgical intensive care unit for resuscitation and treatment. Is PN therapy indicated in this patient?

What other patient data should be collected to help formulate a PN prescription?

Parenteral crystalline amino acid bulk solutions are supplied by various manufacturers in various concentrations (e.g., 3.5%, 5%, 7%, 8.5%, 10%, 15%, and 20%). Different formulations are tailored for specific age groups (e.g., adults and infants) and for some disease states (e.g., kidney and liver disease). Specialized formulations for patients with acute kidney injury contain higher proportions of essential amino acids. Formulations for patients with hepatic encephalopathy contain higher amounts of branched-chain and lower amounts of aromatic amino acids. However, these specialized formulations are not used routinely in clinical practice because their efficacy and role in improving patient outcomes has not been clearly demonstrated. Crystalline amino acid solutions have an acidic pH (pH ~ 5 to 7) and may contain inherent electrolytes (e.g., sodium, potassium, acetate, and phosphate).

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