Good morning to all. For many years, when a term or preterm neonate was admitted in a hemodynamically unstable state to the hospital where I did my fellowship, these neonates were generally managed with intravenous fluids that included dextrose, sodium, potassium and calcium exclusively before deciding to start the enteral route with MEF or administer TPN (this due to lack of the unit). My question is, in this case of hemodynamically unstable patients, and because they may present systemic arterial hypotension and variations in central glycemic levels, would the use of total parenteral nutrition be recommended? That is, how to deal with these variations in blood pressure. central glucose or make adjustments in the amount of fluids to be infused in 24 hours if the patient suddenly worsens and the patient already has TPN ?. Thank you for your kind attention and your comments, I send you my infinite gratitude