Very preterm infants, who often have relatively delayed gastric emptying and intestinal peristalsis, may be slow to tolerate the introduction of gastric tube feeds. These infants may need intravenous nutrition while enteral nutrition is being established or when enteral nutrition is not possible—for example, because of respiratory instability, feed intolerance, or serious gastrointestinal disease.
Complications of total parenteral nutrition Total parenteral nutrition consists of a glucose and amino acid solution with electrolytes, minerals, and vitamins, plus fat as the principal non-proteinenergy source. The solutions are usually prepared in a specialist pharmacy to minimise the risk of microbial contamination. Bloodstream infection is the most common important complication of parenteral nutrition use. Delivery of the solution via a central venous catheter rather than a peripheral catheter is not associated with a higher risk of infection. Extravasation injury is a major concern when parenteral nutrition is given via a peripheral cannula. Subcutaneous infiltration of a hypertonic and irritant solution can cause local skin ulceration, secondary infection, and scarring.