Nutrition for Neonates Undergoing Surgery for CHD — Titrate Parenteral with Oral Feeds — Clinical Pathway: Inpatient

Nutrition for Neonates with Congenital Heart Disease Clinical Pathway — CICU

Titrate Parenteral with Oral Feeds (Preoperative)

Parenteral nutrition (PN) is typically written with a volume of maintenance fluids or less (≤ 100 mL/kg/day). Closely monitor oral intake volumes and adjust PN as defined below so the patient does not exceed a TFL of 150 mL/kg/day. This will prevent fluid overload.

Assess Volume of Oral Feeding to Determine Appropriate Volume of PN:

  • At the beginning of each shift, calculate previous 12-hour oral intake (mL/kg). Discuss how to adjust the PN volume to maintain desired TFL.
  • Modify rate of PN order as needed with titration of oral feeds.

Titrate Parenteral with Oral Feeds

Oral Intake Recommended PN
< 50 mL/kg/day 80-100 mL/kg/day
50-100 mL/kg/day 50 mL/kg/day
> 100 mL/kg/day Discontinue PN