When should I consider referring a patient for specialist assessment regarding their need for parenteral nutrition?

Consider referring a patient for specialist assessment regarding their need for parenteral nutrition if they are malnourished or at risk of malnutrition and have either inadequate or unsafe oral and/or enteral nutritional intake, or a non-functional, inaccessible, or perforated gastrointestinal tract ¹.

Referral should also be considered if the patient requires parenteral nutrition due to complex needs such as short bowel syndrome, increased stoma losses, or slow growth, which may necessitate long-term parenteral nutrition ².

Additionally, if the patient's nutritional requirements cannot be met safely through oral or enteral routes, or if there are complications or uncertainties in management, specialist assessment is indicated ¹.