Compared to enteral or hypocaloric oral nutrition, the use of PN (
parenteral nutrition) is not associated with increased mortality, overall frequency of complications, or longer length of
hospital stay (LOS). The risk of PN complications (e.g.
refeeding-syndrome, hyperglycaemia, bone demineralisation,
catheter infections) can be minimised by carefully monitoring patients and the use of nutrition support teams particularly during long-term PN. Occuring complications are e.g. the
refeeding-syndrome in patients suffering from severe
malnutrition with the initiation of refeeding or metabolic,
hypertriglyceridemia, hyperglycaemia,
osteomalacia and
osteoporosis, and hepatic complications including
fatty liver,
non-alcoholic fatty liver disease,
cholestasis,
cholecystitis, and
cholelithiasis. Efficient monitoring in all types of PN can result in reduced PN-associated complications and reduced costs. Water and electrolyte balance,
blood sugar, and cardiovascular function should regularly be monitored during PN. Regular checks of serum
electrolytes and
triglycerides as well as additional monitoring measures are necessary in patients with altered renal function,
electrolyte-free substrate intake,
lipid infusions, and in
intensive care patients. The metabolic monitoring of patients under long-term PN should be carried out according to standardised procedures. Monitoring metabolic determinants of bone metabolism is particularly important in patients receiving long-term PN. Markers of intermediary,
electrolyte and
trace element metabolism require regular checks.