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TABLE OF CONTENTS
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| 1 | Nutritional Management of the Critically Ill Surgical Infant
Bodil Larsen B.Sc., RD, Ph.C.
The nutritional management of the critically ill infant is a complex and
challenging task. This diverse patient population presents many barriers when
applying concepts of enteral and parenteral nutrition formulation. Energy
expenditure determination becomes difficult in the face of the physiologic and
metabolic stress the infant is experiencing. The use of laboratory parameters
(biochemistry) becomes critical in determining the path we choose as clinicians.
This article provides direction and guidance for the thought process nutrition
clinicians should consider when practicing in this area of expertise. What can we
do for these infants and where do they go from here? |
| 3 | Evaluating Trace Element Status in Long-Term Parenteral
Nutrition-Dependent Pediatric Patients
Carrie L. McFarland RD, CNSD
Parenteral nutrition (PN) in pediatrics
became a standard clinical practice in
the 1960s. It was at this time that multitrace
element solutions were developed.
Much of the research supporting the
needs for these trace elements was
conducted in the 1960s and 1970s.
Patients have survived over thirty years
receiving exclusive PN. In light of the
long-term survival rates, the need to
evaluate the trace element regimen with
the goal of providing optimal care has
come to the surface.
Our center conducted a quality
improvement project to create evidencebased
guidelines for the management
of trace element status of pediatric
patients dependent on long-term PN
(defined as receiving PN for at least
three months consecutive). This article is
a review of our medical center's
findings and conclusions, organized by
individual element. |
| 6 | Considerations in Pediatric Oncology Parenteral Nutrition Support
Jennifer Webb MS, RD
Medical nutrition therapy (MNT)
in pediatric oncology is complicated
by the metabolic consequences
of cancer and the side effects of the
various therapies. The many types
of cancer and the numerous invasive,
toxic therapies interfere with
the body's ability to nourish itself.
For this reason, children with cancer
undergoing treatment often
find it difficult to maintain optimal
nutrition (1). MNT for children with
cancer can range from supportive
nutrition education to long-term
parenteral nutrition (PN). The
Registered Dietitian (RD) working
with this population must be able
to evaluate the patient's nutritional
status, discern his/her ability to
continue to meet nutritional needs
by mouth, and determine the point
when PN may become necessary.
This article outlines the indications
for PN in the pediatric oncology
population and makes recommendations
for PN components to best
meet the nutritional needs of these
patients. |
| 10 | Home PN Team Case Study: Infant with Short Bowel Syndrome
Diane Barsky MD, Robin Meyers MPH, RD, LDN
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| 13 | Case Study: Nutrition Support for Infants with CHD
Susan Bessler, MS, RD, CSP
Children with congenital heart disease
(CHD) often grow poorly. The extent and
duration of growth failure varies widely
depending on the specific defect and its
severity. The etiology of poor growth is
thought to be multi-factorial and
includes insufficient energy intake due
to fatigue and early satiety, elevated
metabolic rate, gastrointestinal
dysmotility, and malabsorption. At
some point before or after corrective or
palliative surgery children with CHD may
require nutrition support to meet their
nutrient requirements. |
| 15 | From the Editor
Liesje Nieman Carney, RD, CNSD, LDN
Firstly, I want to extend my congratulations to the Pediatric Nutrition Symposium planning committee for hosting a
first-rate conference in April. We were so pleased with the tremendous turn-out, and were excited to see that many of the
attendees are interested in becoming active in PNPG. The speakers were dynamic and informative, and the location was
ideal (especially for those of us who needed a reprieve from the cold weather). |
| 17 | Resource List: Parenteral Nutrition In Various Pediatric Conditions and Disease States
Beth Wallace, RD, CNSC, LDN
Co-Chair, PNPG Nutrition Support Special Interest Group |
Copyright 2009 Pediatric Nutrition Practice Group, ADA.
The BUILDING BLOCK FOR LIFE is published quarterly by
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FOR THIS ISSUE:EDITORLiesje Nieman Carney, RD, CNSD, LDN
Children's Hospital of Philadelphia
34th Steet and Civic Center Boulevard
Philadelphia, Pennsylvania 19104-4399
Co-EDITORCheryl Lair, RD/LD, CSP, CBE
Parkland Health and Hospital System
5201 Harry Hines Boulevard
Dallas, Texas 75235 LOOKING AHEADVolume 32, No. 3 will feature: Nutrition Care Process
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