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managed. Patients with type 1 diabetes have an absolute requirement for exogenous insulin for survival. Therefore, it is essential that

Diabetes, corticosteroid use, and age are factors that increase the likelihood of requiring insulin during HPN therapy.22 Blood glucose can be controlled by decreasing the dextrose content and increasing the lipid content, adding insulin to the PN formula, or lengthening the infusion period.23 Monitoring blood glucose to manage

manage infections and sepsis. Promote proper venous catheter care to avoid catheter-related infections. 77Intestinal rehabilitation (may decrease risk) Minimize PN dependency by optimizing nutrient absorption through pharmacology and dietary interventions to increase intestinal absorptive capacity. Medications Eliminate hepatotoxic medications. Other Consider evaluating for non-PN etiologies, such as hepatitis

diabetes, or pulmonary dysfunction) guides the development of a 3comprehensive nutrition care plan. Confirmation of seriously altered or absent GI tract function may be obtained from intake and output reports, results of an EN trial, radiology (eg, CT scan or x-ray) or surgery reports, and GI studies (eg, endoscopy