Enteral and Parenteral Nutrition

1. While volume status is normally controlled by renal function and thirst, individuals maintained solely on prescribed enteral or parenteral alimentation are at increased risk for electrolyte and volume status disorders. 2. When fluid intake is limited, enteral formulas with higher osmolar concentration may lead to an osmotic diuresis and dehydration. 3. During the early phases of enteral or parenteral nutrition, fluid and electrolyte intakes should be monitored and adjusted on a regular basis. 4. The refeeding syndrome is a disorder due to metabolic abnormalities occurring in malnourished patients undergoing the initial phase of enteral or parenteral refeeding. 5. Serum potassium and phosphate concentrations may be normal prior to the initiation of eneral or parenteral regimens, only to decrease to dangerous levels early in the course of refeeding. 6. Provision of trace elements is necessary to prevent the development of trace element deficiencies associated with the rapid restoration of body mass. 7. Specific groups within pediatrics (e.g., neonates, those with renal insufficiency or eating disorders) require special attention when prescribing enteral or parenteral nutrition.