RECENT ADVANCES IN PARENTERAL-NUTRITION

Nutritional support of critically ill infants and children has a major impact on the morbidity and ultimate survival of these patients. Pare nteral nutrition has undergone many changes since its original use mor e than 20 years ago. This article summarizes some of the more recent m odifications in parenteral nutrition. The use of insulin to control hy perglycemia associated with parenteral nutrition is controversial, alt hough many advocate its use as a means to optimize caloric intake in t he very low-birthweight infant for whom this is often a significant pr oblem. The advantages of using a 20% lipid emulsion, as opposed to a 1 0% emulsion, are emphasized. Supplementation with carnitine and seleni um is controversial, and studies endorsing and opposing their use are described.