Historical Development of Intravenous Nutrition Applications In the mid-1960s, stenleydudrick et al. successfully solved the problem of providing nutrition without causing fluid overload by dripping hypertonic glucose and hydrolyzed proteins for a longer period of time through a subclavian vein catheter, which has led to the start of the use of intravenous endovenous nutritional techniques for clinical use. In the 1970s, crystalline amino acids (CAA) replaced hydrolyzed proteins, and intravenous fat emulsions were applied. In the 80’s, trace elements were used in clinical practice, and special intravenous nutrient solutions suitable for the needs of patients with different conditions were prepared. In 1972, Solassal and other researchers in France used the mixture of fat emulsion, amino acid and glucose for PN, which was called “three-one” nutritional solution, and later mixed electrolytes, vitamins and trace elements in nutritional solution, which was called “all-in-one” nutritional solution. Nutrient solution. In 1988, the American Society for Parenteral and Enteral Nutrition (ASPIN) called it a total nutritional mixture. Since the 1970s, intravenous nutrition has been widely used in neonates, not only to make the neonatal mortality rate decline, and improve the quality of life, even if its growth and brain development and normal neonates similar to the neonatal therapeutic and nutritional breakthroughs, at present, domestic conditions of large and medium-sized hospitals have carried out this technology, widely used in congenital digestive malformations (such as esophageal atresia, intestinal atresia), acquired gastrointestinal disorders (e.g. esophageal atresia, intestinal atresia), and the development of the digestive tract. Acquired gastrointestinal disorders (necrotizing small bowel colitis, short bowel syndrome, etc.), and premature infants who cannot tolerate gastrointestinal feeding and other neonatal treatment areas. Why intravenous nutrition for newborns? Fetuses receive intravenous nutrition through the placenta in the uterus, and their growth and development after birth depend on whether or not they can receive adequate nutrition from the gastrointestinal tract. Preterm infants, especially very low birth weight infants, have a significant deficit in energy reserves (1% of body weight at 24 weeks of gestational age, 3.5% at 28 weeks of gestational age, and more than 12% in mature infants), and without early nutrition, they can suffer from a high incidence of diabetes. If nutrition is not provided early, the baby can die within a few days. Nutrition is not only for physical development but also for brain tissue development, human brain development has two rapid growth period, the first is 15-20 weeks in utero, mainly for the proliferation of nerve cells, the second occurs from 25 weeks in utero to 2 years after birth, mainly for the proliferation of neuroglia, such as malnutrition during this period will affect the development of the brain, resulting in the small size of brain tissue, the number of brain cells decreases, and this change is irreversible. Therefore, the application of neonatal intravenous nutrition can make the neonate’s morbidity and mortality rate decrease, and make the quality of life improve, even if its growth and brain development is similar to that of normal neonates, which is an important breakthrough in neonatal therapeutics and nutrition. At present, the neonatology department of our hospital continues to develop, and the trend of children who can not tolerate gastrointestinal feedings is increasing, and there is not a single hospital with a perfect neonatal intravenous nutrition system in Cangzhou. At present, our neonatology department is developing continuously, and the number of children who cannot tolerate gastrointestinal feeding is increasing gradually. In addition, our hospital has mature conditions to carry out this technology, there are professional neonatologists to formulate the formula and evaluate the therapeutic effect; there is a perfect medical security system to ensure the smooth implementation of this technology; there is the only laminar flow liquid preparation room in the city to ensure the sterility of the preparation process; there are trained professional preparation staff to ensure the quality and safety of the nutritional solution preparation. Therefore, we have developed this technology. Indications and contraindications of intravenous nutrition for newborns (a) Indications For various reasons, gastrointestinal feeding cannot be carried out for more than three days or cannot meet the demand for calories 70% of newborns. (1) Total gastrointestinal nutrition (TPN) (1) Before and after surgery for severe congenital digestive malformations (e.g. esophageal atresia, intestinal atresia, etc.). (2) Acquired gastrointestinal disorders (necrotizing small bowel colitis conservative medical treatment, intractable diarrhea, intestinal fistula, chronic intestinal obstruction, short bowel syndrome, etc.). (3) Premature infants (low birth weight, very low birth weight and ultra-low birth weight) with immature gastrointestinal function, especially with respiratory distress, frequent apnea can not tolerate intra-gastrointestinal feeding. (4) Large burns. (2) Partial intravenous nutrition (PPN) (1) Preterm infants within one week of day old with birth weight between 1kg-1.5kg and caloric intake <90kcal/Kg/d. (2) Preterm infants more than one week of day old with caloric intake <80kcal/Kg/d. (3) Extrauterine newborns with growth and developmental retardation. (B) Absolute and relative contraindications 1, severe infected neonates, should be used with caution while receiving effective antibiotic therapy. 2.Severe hypoxia, dehydration and metabolic acidosis pen chipping should be applied after correction. 3, circulatory failure, severe hepatic and renal insufficiency, urea nitrogen > 12.9mmol / l (36mg / dl) should be used with caution or prohibited under close monitoring depending on the condition of the fat milk and non-hepatic, renal and specialized amino acids. In case of shock, rehydration for the purpose of nutritional support should be prohibited. 4.Indirect bilirubin>170umol/l and/or albumin<25g/l, platelet reduction, yo severe bleeding tendency of people under close monitoring with caution in the use of fat emulsion. 5, do not have the monitoring equipment and medical care conditions and micro-biochemical detection technology, it is advisable to transfer to the conditions of the application of medical units. Advantages of neonatal intravenous nutrition technology This technology has been used for many years in large domestic hospitals, practice has proved that this technology is safe and effective, greatly reducing the neonatal mortality and disability rate, as long as a strict grasp of the indications, strict operation process, can avoid the emergence of a variety of complications; the application of intravenous nutrition technology is a preterm baby's hospitalization time has been greatly shortened to reduce the pressure on the family. At present, hospitals still use the method of multi-container infusion for the infusion of nutrient solution, compared with this, this technology has the following advantages: 1, reduce the chance of contamination of each nutrient solution, a one-time in the aseptic conditions to complete the preparation. 2.Improve the effect of nutritional support, because amino acid and non-protein heat source input at the same time, can improve the utilization of nitrogen, and is conducive to protein synthesis. 3.Reduce the occurrence of complications, hyperglycemia and liver damage. 4.Simplify the operation of nurses and facilitate nursing care.