1500 - 2000 grams 3 mLs, 2000-2500 grams 4 mLs, greater than 2500 grams 5
mLs.
Additional medications may be provided as part of parenteral nutrition.
Heparin may be added in small amounts to help maintain patency of central
lines.
B. Ordering Total Parenteral Nutrition
Initiation of parenteral nutrition should begin with 25-30 kcal/kg/day with
advancement over several days to reach goal calories. Adults and adolescents
usually receive 35 kcal/kg/day. Term infants should receive 80-100 kcal/kg/day
and preterm infants at least 90-110 kcal/kg/day. Goals for weight gain are 20
g/kg/day for infants less than 37 weeks gestational age and 30 g/kg/day patients
for infants greater than 37 weeks gestational age.
The initial glucose infusion rate for infants should be 4-6mg/kg/minute
advancing 2 mg/kg/minute each day as long as the serum glucose remains less
than 150 mg/dL to the maximum of 12-14 mg/kg/minute. Exceeding the upper
limit of 14 mg/kg/minute may result in overfeeding and fatty infiltration of the liver.
[ 5 ] In addition, overreliance on glucose causes excessive CO2 production which
theoretically could be detrimental to patients with compromised ventilatory
function.