Blood gas

• Check electrolytes daily

Serum U and Es:

• Check every 3 days in the first week and then weekly as required
• Check 24 hours after making changes to additives

Neonatal Screen (NNS)

• Check weekly

Triglycerides

• Check after 72 hours of starting lipids and then again 48 hours after starting 3.5g fat/kg/day (0.83ml/kg/hour SMOF lipid solution) for preterm infants or 3g fat/kg/day (0.75ml/kg/hour SMOF lipid solution) which is maximum for term infants.
• Once stable triglycerides should be checked weekly.
• If > 3mmol/l then discuss reducing this with pharmacist/consultant.
• Measure when a baby becomes seriously ill (particularly if there is significant metabolic acidosis, hypotension, thrombocytopenia, or coagulopathy)
• When sending biochemistry samples, always record in the clinical information section that the baby is on PN. The lab will then automatically check for visible lipaemia.

Further investigations:

Further blood testing may be required which should be discussed with a senior clinician if clinically indicated.