THE PHYSIOLOGIC BASIS FOR ESTIMATING REQUIREMENTS FOR PARENTERAL FLUIDS

The intravenous use of fat for the total parenteral nutrition of the infant

A new program for the total iv feeding of the postoperative neonate has been described and evaluated. The program is based on a crystalline 1‐amino acid solution as the nitrogen source and a soybean fat emulsion as the major source of calories. This program has three main advantages over ones based on hypertonic glucose as the main calorie source: (a) no central venous catheter is needed, (b) the complication of osmotic diuresis is eliminated, and (c) the high caloric value of fat allows small volumes of fluid to be infused into the infant. The present regimen has been shown to sustain nitrogen and potassium retention in amounts similar to those found in normal newborns and in other parenteral feeding programs. In the initial phase of this study, 32 newborns were treated with this program and 26 survived, following surgery for life‐threatening congenital anomalies. Since this first evaluation, over 75 infants have been placed on this iv feeding protocol.