Which of the following best describes the risk profile associated with total parenteral nutrition in neonates?

• A. Infection, hyperglycemia, electrolyte imbalance, liver dysfunction, and catheter-related complications.
• B. Only dehydration.
• C. No risk.
• D. Increased risk of polycythemia.

Answer: (A)

Total parenteral nutrition in neonates carries multiple intertwined risks because it requires a central venous catheter and delivers age- and condition-sensitive nutrients directly into the bloodstream. The most important risks relate to the line itself and the metabolic load of the solution. Infection or catheter-related bloodstream infection is a major concern since the access device provides a portal for organisms. The high dextrose content can cause hyperglycemia, especially in preterm or fragile infants with immature glucose regulation. Electrolyte imbalances can occur quickly as fluids and minerals are delivered IV and as the infant’s organs adjust to the parenteral supply. Long-term TPN can lead to liver dysfunction, including cholestasis and fatty liver changes, due to altered lipid and nutrient handling. Catheter complications—thrombosis, occlusion, dislodgement, or line infection—are also a key part of the risk profile. In contrast, dehydration is not a primary or defining risk of TPN itself, and TPN does not carry no risk or a risk profile focused on polycythemia, so the listed combination best reflects the common and important neonatal risks.