Cycling parenteral nutrition in a neonatal surgical patient: An argument for increased utilization

Cycling total parenteral nutrition (TPN) limits hepatic dysfunction in adults and children with intestinal failure. Due to immature glucose homeostasis, this method is infrequently utilized in the neonatal population. Herein, we describe a successful case of cycled TPN in a neonate with complicated gastroschisis and short bowel syndrome. Within three weeks the patient had a normalized direct bilirubin and did not require pharmacologic intervention. There were two episodes of asymptomatic hypoglycemia associated with intestinal obstruction.