Parenteral nutrition (PN) represents a critical therapeutic approach for patients unable to meet nutritional needs through oral or enteral routes. In recent years, the development of advanced PN formulations has accelerated, driven by improvements in lipid emulsion design, compound amino acid and micronutrient preparations, and multi-chamber bag (MCB) technologies. These innovations not only enhance safety, stability, and metabolic efficiency but also expand the capacity of PN to address increasingly complex clinical scenarios. Novel lipid emulsions derived from mixed-oil systems, structured triglycerides, and ω-3 polyunsaturated fatty acids provide both energy support and immunomodulatory effects. Advances in mixed micelles and nanoemulsion-based delivery systems have improved the solubility and chemical stability of labile vitamins and trace elements, while modern MCB systems reduce infection risk and simplify compounding procedures. Despite these advancements, significant challenges remain in translating laboratory progress into standardized clinical practice. Variability in formulation selection criteria, limited physicochemical stability in all-in-one systems, insufficient adaptability for pediatric and home PN populations, and inconsistencies in manufacturing quality and regulatory oversight all restrict broader clinical adoption. Moreover, the absence of unified evaluation standards for stability, compatibility, and clinical safety continues to hinder evidence-based optimization. This review summarizes the current progress and unresolved issues associated with advanced PN formulations, with particular focus on lipid emulsions, amino acids, vitamins, trace elements, and MCB technologies. Future directions include establishing multidimensional evaluation frameworks, promoting individualized and precision nutrition strategies, improving formulation processes, and strengthening global regulatory harmonization.
Zhao et al. (Sun,) studied this question.