Example of a step-wise approach to cycling parenteral nutrition

Continuous	Continuous 24-hour parenteral nutrition	1000 mL infusing at 42 mL/hr for 24 hours
Start of cycling	22 hours on, 2 hours off	48 mL/hr × 20 hours 24 mL/hr × 1 hour (Cycle down) 12 mL/hr × 1 hour (Cycle down) Off 2 hours
Step 2	20 hours on, 4 hours off	25 mL/hr × 1 hour (Cycle up) 55 mL/hr × 17 hours 25 mL/hr × 1 hour (Cycle down) 15 mL/hr × 1 hour (Cycle down) Off 4 hours
Step 3	18 hours on, 6 hours off	35 mL/hr × 1 hour (Cycle up) 61 mL/hr × 15 hours 35 mL/hr × 1 hour (Cycle down) 15 mL/hr × 1 hour (Cycle down) Off 6 hours
Step 4	16 hours on, 8 hours off	36 mL/hr × 1 hour (Cycle up) 70 mL/hr × 13 hours 36 mL/hr × 1 hour (Cycle down) 18 mL/hr × 1 hour (Cycle down) Off 8 hours

Example of a step-wise approach to cycling parenteral nutrition. The cycle length achieved will be dependent on the glucose infusion rate (GIR) and the glucose tolerance of the individual patient.

Courtesy of Susan Baker, MD, Robert Baker, MD, Jessica Briggs, RD, and Georgina Bojczuk, RD, CSP.

Graphic 90966 Version 3.0

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Example of a step-wise approach to cycling parenteral nutrition