Parenteral Nutrition (PN)is a compounded medical intravenous solution that can provide all nutritional requirements to patients who cannot, should not, or will not eat adequately to maintain their nutrient stores. These patients are already, or have the potential of becoming, malnourished. This is currently provided to critically ill patients with inadequate oral intake for 7 days, or in those patients in whom inadequate oral intake is expected over a 7 days period. Examples of these patients include burn victims, peri-operative support of patients with moderate to severe malnutrition, acute exacerbations of Crohn’s disease, GI fistulas, extreme short bowel syndrome, critical care patients who will be NPO for prolonged periods of time, and severe acute necrotizing pancreatitis. The most patient population in need of TPN are Neonates where PN should be initiated within the first 24 hours post-partum if enteral feeding could not or will not be tolerated for 2 – 3 days. In addition to these situations, PN should be used when the gastrointestinal tract is not functional or can-not be accessed and in patients who cannot be adequately nourished by oral diets or Enteral Nutrition.

Currently all parenteral nutrition (PN) compounding in the UAE is done by individual hospitals. There are variability compounding practices, in addition to quality and safety metrics. Many facilities in the region do not meet USP 797 standards for intravenous preparations. This dilutes quality, presents a safety risk, and increases chances for negative outcomes. A large reason for this is the lack of an individual hospital being able to leverage economies of scale in the production of PN and other intravenous preparations.

Recognizing the disadvantages of maintaining a small-scale parenteral nutrition production line, over half of all hospitals in the United States have outsourced their PN production to independent entities. Additionally, there is another category of patients who is clinically stable and would be a candidate for discharge if not for their continued PN requirement. Their continued hospitalizations expose patients to increased costs, decreased quality of life, and put them at risk for hospital acquired infections. The only barrier to these patients’ discharge is the lack of outpatient PN. PN not only aim at caloric and nutrients provision to patients, but also a significant tool in reversing the inflammatory process and managing underlying clinical illnesses, saying so means that TPN is a valuable clinical modality