MONITORING AND COMPLICATIONS OF PARENTERAL-NUTRITION

A knowledge of the complications of parenteral nutrition is inherent i n the design of any monitoring system. In the initial stages of therap y, the complications are usually of electrolyte imbalance. It must als o be appreciated that the provision of nutrition to severely malnouris hed patients will expose underlying deficiencies, particularly of phos phates and trace elements. In long-term parenteral nutrition, the comp lications can be broadly divided into those associated with the line a nd metabolic complications. The line complications include: line block age, sepsis, and pulmonary embolism. The most important metabolic comp lication is undoubtedly liver cholestasis, which may be associated wit h recurrent episodes of sepsis. Any department undertaking long-term p arenteral nutrition should have an active nutrition team to avoid comp lications and audit outcome. (C) Elsevier Science Inc. 1998.