Sodium Free Bag (10% Glucose and 2.27g Protein/100ml)

• If clinically indicated, a sodium free bag could be used for term infants up to a maximum of 110ml/kg/day of aqueous solution in addition to 0.83ml/kg/hour (20ml/kg/day) SMOF lipid solution.
• This bag is not deigned for long term use. Please ensure dietitian is aware if this is to be used.
• Please note further electrolyte additions cannot be made to this bag as maximum additions have already been added.

Standard Bag (12.5% Glucose and 2.88g Protein/100ml)

• This PN regimen should commence at 48ml/kg/day of aqueous solution on day 1 of life for term infants and 0.5ml/kg/hour (12ml/kg/day) SMOF lipid solution. Total aqueous and lipid solutions provide 60ml/kg/day which is in line with the local fluid protocol.  If more fluid is indicated, a maximum of 60ml/kg of this aqueous solution could be used in addition to lipid solution at 12ml/kg/day as above. (ie 72ml/kg/day total aqueous and lipid solutions)
• This PN regimen should increase up to a gradual maximum (ie after 3-4 days) of 80ml/kg of aqueous solution with 0.83ml/kg/hour (~20ml/kg/day) SMOF lipid solution. (Total aqueous and lipid solutions provide 100ml/kg/day)
• The addition of 0.83ml/kg SMOF lipid solution provides slightly more calories than required however it has been agreed to use this in the short term for simplicity of PN management across the unit. If a baby is to continue on this regimen longer term the lipid content may be reduced which can be discussed with dietetics/pharmacy.

Central Bag (16% Glucose and 3.1g Protein/100ml)

• This PN regimen can be used at a maximum volume of 80ml/kg/day of aqueous solution for term infants in addition to 0.83ml/kg/hour (~20ml/kg/hour) SMOF lipid solution (Total aqueous and lipid solution provide 100ml/kg/day)
• Phosphate and Calcium levels in this bag meet the minimum requirements for term infants.
• Note there is no potassium added to this bag so an appropriate amount should be added. For reference, growing term infants require 1.5 – 3mmol/kg/day of potassium (ESPGHAN 2018)
• With any electrolyte adjustments please be guided by serum levels.