Patient Selection Criteria

The following criteria may be useful in the selection of appropriate candidates for IDPN/IPN:

• Patient has a trending albumin of 3.5 gm/dL or less.
• Patient has a disease or impairment that may affect the absorption of nutrients or require additional nutrients to maintain weight and strength.

	Short bowel syndrome	Cancer/chemotherapy
	Inflammatory bowel disease – Crohn’s disease – Ulcerative colitis – Bowel fistula	Chronic nausea/vomiting/diarrhea
		Wounds that are healing poorly
		Chronic inflammation/infections
	Ostomies	Dysphagia/severe mechanical alterations in diet
	HIV/AIDS	Chronic anorexia
	Diabetic gastroparesis	Early satiety

• Patient demonstrates protein/energy wasting.
• Patient demonstrates a progressive decline in weight or is significantly below standard body weight (SBW), if applicable.
• Subjective global assessment (SGA) yields a rating of 4 or below on a scale to 7.
• Patient demonstrates an inability to administer or tolerate oral supplements and/or tube feedings.

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Records should indicate that the patient cannot be maintained on oral/enteral feedings and the patient’s clinical condition warrants more aggressive nutrition therapy. The clinical/laboratory documentation used for IDPN/IPN are:

• Albumin levels and other routine blood chemistries
• Current body weight, weight history, and weight loss, if applicable
• Current medications
• Allergies, if any
• Indications of oral intake and problems such as diarrhea, vomiting, and nausea
• RD monthly/quarterly progress notes and/or annual assessment
• Documentation of co-morbidities that would increase the nutritional needs and/or interfere with nutrition

Please note: No single parameter should verify a patient’s eligibility for IDPN/IPN therapy. Please consult your NutrePletion dietitian at 800.626.4427 if you have any questions about an appropriate patient.