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Parenteral Nutrition

Parenteral nutrition (PN ) is indicated when oral or enteral nutrition is not feasible, not adequate or not tolerated. By bypassing the gastrointestinal tract via intravenous administration, PN supports the body with adequate nutrients.
For PN single bottles of amino acids, glucose and lipids are traditionally prepared at the hospital pharmacy by compounding the different required components into one mixing bag under aseptic conditions. This procedure is time-consuming and requires extensive technical equipment and pharmaceutical knowledge.

That is why Multi-Chamber Bags have become increasingly popular in recent years. Two and three chamber bags for peripheral and central venous application are available.

Two chamber bags consist of a glucose and an amino acid chamber. If needed, a lipid component can be added separately.

Three chamber bags include one chamber for glucose, one for amino acids and one for lipids. Multi-Chamber Bags are available with or without electrolytes. Additional electrolytes and vitamins can be added to the Multi-Chamber Bags when necessary.

Indications and applications for Parenteral Nutrition

  • Where Enteral Nutrition is contraindicated.1
  • "Postoperative parenteral nutrition is beneficial in patients with postoperative complications impairing gastrointestinal function who are unable to receive and absorb adequate amounts of oral/enteral feeding for at least 7 days".1
  • When the gut has failed or administration of EN is impossible for other reasons (e.g. prolonged ileus, complex pancreatic fistulae, abdominal compartment syndrome).2
  • Prevention and treatment of under-nutrition / cachexia3
  • PN is recommended in patients with severe mucositis or severe ratiation enteritis3
  • Home parenteral nutrition is recommended for patients with malignant obstruction or partial obstruction of the gastrointestinal tract provided that they do not suffer from severe organ dysfunction.4

Routes of administration

  • Peripheral venous
  • Central venous


  • 1. M. Braga et al.;ESPEN Guidelines on Parenteral Nutrition: Surgery; Clinical Nutrition 28 (2009); 378-386
  • 2. L. Gianotti et al.; ESPEN Guidelines on Parenteral Nutrition: Pancreas; Clinical Nutrition 28 (2009); 428-435
  • 3. F. Bozzetti et al.; ESPEN Guidelines on Parenteral Nutrition: Non-surgical oncology; Clinical Nutrition 28 (2009); 445-454
  • 4. M. Staun et al.;ESPEN Guidelines on Parenteral Nutrition: Home Parenteral Nutrition (HPN) in adult patients; Clinical Nutrition 28 (2009); 467-479