TABLE OF CONTENTS
2	Guest Editor’s Perspective Therese Austin, MS, RD, CNSDbitm When I was deciding on a theme for this issue of Support Line, I was reflecting on my own practice in nutrition support. I thought about specific patient care situations that I found challenging and took me out of my comfort zone. Clinicians at all levels of experience encounter clinical scenarios that are out of the ordinary practice for which it can be challenging to establish care plans that are safe and appropriate for patients.
2	Chair’s Column Ainsley Malone, MS, RD, CNSD It is amazing to me that 10 months have passed and I am writing my final Chair’s column. It truly seems just a short while ago that I was drafting my first column for the August 2007 issue. The sometimes overused verbiage, “time flies when you’re having fun” couldn’t better express my thoughts of serving as your Chair for 2007-2008.
3	Challenges With Central Venous Access Devices in Adults Receiving Home Parenteral Nutrition Kathy Hammond, MS, RN, RD, CNSD Home parenteral nutrition (HPN) allows many people to maintain active lifestyles outside of the hospital. Providing this high-tech care in the home requires a commitment from the clinician, patient, and caretaker. Even with meticulous care and monitoring, central venous access devices (CVADs) can be a challenge to maintain. It is essential to prevent rehospitalization and adverse effects in this patient population. Potential complications associated with such devices can be related to infection or catheter occlusions. Catheter occlusions are categorized further as thrombotic- and nonthrombotic-related complications. Nonthrombotic catheter occlusions include precipitation of drug solution and mechanical causes.
12	Sodium Homeostasis Sheela Thomas, MS, RD, CNSD , K. Joy Lehman, PharmD, BCNSP Sodium is an electrolyte that is necessary in almost every metabolic process from the utilization of macronutrients to intracellular transport. Sodium disorders are common and usually asymptomatic, but severe or rapid changes in the serum sodium concentration can lead to life-threatening sequelae. In addition, rapid correction of abnormal sodium values can lead to dangerous adverse effects. Therefore, the clinician should be aware of the normal pathophysiology of sodium and its relationship to total body water (TBW) and serum osmolality. This review examines sodium homeostasis, differential diagnoses for hypo- and hypernatremia, and the appropriate treatment for these disorders.
21	Standardized Parenteral Nutrition: What Does This Mean? Marty Kochevar, MS, RPh, BCNSP The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) developed a Task Force in response to questions regarding use of standardized parenteral nutrition (PN) formulations. The Task Force reviewed the current literature and developed recommendations, standardized process recommendations, and areas for future research. A standardized process may include use of standardized PN formulations (including standardized commercial PN products), but also includes aspects of ordering, labeling, screening, compounding, and administering PN. A safe PN system must minimize procedural incidents and maximize the ability to meet individual patient requirements. Using clinicians who have nutrition support therapy expertise can contribute to a safe PN system. Standardized PN formulations can improve the efficiency, economy, and simplicity of PN delivery systems, but appropriate standardized formulations are determined best by the individual health-care organization.

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Viewpoints and statements in these materials do not necessarily reflect the policies and/or official positions of The American Dietetic Association or DNS.

SUPPORT LINE (ISSN 1067-3768) is published bi-monthly. $60 for individual non-member subscriptions, $120 for institutions per year (plus postage surcharges for international subscriptions). Newsletter subscriptions are available to interested parties who are ineligible for ADA membership. Published by Dietitians in Nutrition Support, a dietetic practice group of The American Dietetic Association (ADA), 120 S. Riverside Plaza, Suite 2000, Chicago, IL 60606. Send requests for subscriptions to Jamie Diamond, MS, RD, CNSD, 3850 Galt Ocean Drive, Apt. 2009, Fort Lauderdale, FL 33308. For address changes: Please submit name and address changes directly to the Membership Team of the American Dietetic Association using the address change card in the Journal of the American Dietetic Association. SUPPORT LINE is indexed in the Cumulative Index to Nursing and Allied Health Literature.

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