ESPGHAN Paediatric PN Tool: bringing guideline recommendations to the bedside

Providing parenteral nutrition (PN) to infants and children requires careful consideration of age-specific nutritional requirements, growth, underlying disease and the risk of both under- and over-feeding. While evidence-based guidelines are available, translating detailed recommendations into everyday clinical practice can be challenging. 

The ESPGHAN Paediatric PN Tool is an interactive online resource designed to support implementation of the 2018 paediatric parenteral nutrition guidelines developed by the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), European Society for Clinical Nutrition and Metabolism (ESPEN), European Society for Paediatric Research (ESPR) and Chinese Society for Parenteral and Enteral Nutrition (CSPEN). 

The tool presents selected guideline information according to the patient information entered. It is intended to support access to the published recommendations and is not a prescribing system.

What does the tool do?

Using a patient's age and weight, clinicians can generate guideline-based recommendations for:

• Fluid requirements 

• Glucose requirements 

• Amino acid requirements 

• Lipid requirements 

• Electrolyte requirements 

• Vitamins, Iron and Trace elements 

The output brings together key nutritional recommendations into a single, easily accessible format, reducing the need to manually cross-reference multiple guideline documents. 

Importantly, the tool is intended to support implementation of guideline recommendations rather than act as a prescribing system. Clinical judgement remains essential, and recommendations should always be interpreted within the context of the individual patient's condition and multidisciplinary team (MDT) review. ESPGHAN note that this search tool is designed to support, rather than replace, clinician decision making.

How can I use the tool in practice?

The ESPGHAN PN Tool may be particularly useful for clinicians involved in the nutritional management of children requiring complex nutrition support, including those with: 

• Intestinal failure 

• Short bowel syndrome 

• Surgical gastrointestinal conditions 

• Oncology-related nutritional support needs 

• Long-term home parenteral nutrition requirements 

For healthcare professionals who manage paediatric PN less frequently, the tool can provide a readily accessible reference to support decision-making and reinforce familiarity with current guideline recommendations. It may also serve as a valuable educational resource for clinicians in training or those who are new to paediatric nutrition support. 

For experienced nutrition support teams, the platform provides a convenient way to access recommendations during PN reviews and supports a consistent approach to applying international guidance across different clinical settings.

The ESPGHAN platform offers more than nutrient requirement calculations. Users can also access a suite of complementary guidance documents that address key aspects of paediatric nutrition. 

Complications in Paediatric Parenteral Nutrition 

This guideline provides practical recommendations for preventing, recognising and managing complications associated with paediatric PN. It covers catheter-related issues, medication compatibility, metabolic bone health, liver complications and growth monitoring, supporting safer long-term nutritional care. 

Home Parenteral Nutrition (HPN) 

This guideline outlines the principles of delivering PN safely in the home environment for children requiring long-term nutritional support. It addresses patient indications, service organisation, monitoring and follow up, quality of life considerations and long-term outcomes of HPN. 

Venous Access in Parenteral Nutrition 

Reliable venous access is fundamental to successful PN delivery. This guideline reviews catheter selection, insertion techniques and ongoing catheter care, with a focus on reducing the risk of infection, thrombosis and other access-related complications.

Organisational Aspects of Parenteral Nutrition

This guideline focuses on the systems and processes needed to deliver PN safely and effectively. It highlights the importance of multidisciplinary working, nutritional assessment, treatment planning, monitoring and quality assurance throughout the PN pathway. 

Guidelines for the Evaluation and Treatment of Gastrointestinal and Nutritional Complications in Children with Neurological Impairment

Children with neurological impairment frequently experience feeding difficulties and nutritional complications. This guideline provides recommendations for the assessment and management of gastrointestinal symptoms, growth concerns and nutritional deficiencies to support overall health and wellbeing. 

Standard versus Individualised Parenteral Nutrition 

This guideline discusses the role of both standardised and unlicensed, individualised PN regimens in paediatric practice. It explores the factors influencing PN choice and provides guidance on balancing safety, practicality and the individual nutritional needs of each patient. These resources provide additional context for clinicians involved in the delivery of paediatric nutrition support.

While the ESPGHAN PN Tool provides rapid access to guideline recommendations, it should not replace individualised clinical assessment. 

Factors such as: 

• Organ dysfunction 

• Fluid restrictions 

• Electrolyte abnormalities 

• Intestinal adaptation stage 

• Refeeding risk 

• Complex intestinal failure 

• Oncology-related complications 

may all influence nutritional requirements and require specialist clinical judgement. 

ESPGHAN emphasises that guidelines are designed to support, rather than replace, physician decision-making. Nutritional care should always be tailored to the individual patient and delivered within the context of multidisciplinary review.

Variation in PN composition, monitoring practices and management of complications continues to be recognised across paediatric services. Resources that improve access to evidence-based recommendations can help support greater consistency in practice and facilitate implementation of international guidance. 

By translating guideline recommendations into a practical clinical resource, the ESPGHAN Paediatric PN Tool provides clinicians with a simple way to access age-specific recommendations while supporting education, standardisation and evidence-based care.

Access the tool

Visit the ESPGHAN website and explore the Paediatric Parenteral Nutrition Tool here:

ESPGHAN Paediatric Parenteral Nutrition Tool

Already using tools within your practice? We'd love to hear how it has supported paediatric nutrition care or education within your organisation. Contact the Scientific Affairs team at scientific.affairsUK@fresenius-kabi.com.

For healthcare professionals only. September 2026 GB-NP-2600114