Sarcopenia, which is defined as a decrease in skeletal muscle mass and strength with aging, is an important risk factor in clinical medicine that is associated with mortality, and poor surgical and nonsurgical outcomes. Sarcopenia is now recognized as a multifactorial geriatric syndrome. Cachexia is defined as a metabolic syndrome with inflammation as the key feature, so cachexia can be an underlying condition of sarcopenia. Recently, cachexia has been defined as a complex metabolic syndrome associated with an underlying illness and characterized by the loss of muscle mass with or without a loss of fat mass. These two conditions overlap but are not the same. In clinical practice, many factors related to sarcopenia (decreased food intake, inactivity, and decreased hormones) are reported frequently in patients with cachexia. On the contrary, systemic inflammation, the core feature of cachexia, can also be present in apparently healthy older sarcopenic patients. This suggests that new therapeutic approaches, alone or in combination, may be appropriate in both conditions.

Total parenteral nutrition (TPN) therapy has advanced significantly during the recent half a century, from single bottle therapy to the combined therapy including macronutrients and micronutrients. The purposes of 3-chamber bag development are to reduce the restriction of total nutrient admixture, and increase the accessibility of therapy. This is also based on trial and errors during R&D activities, and the clinical experiences at the hospital compounding centers. The 3-chamber bag started with concerns regarding the mixture of fat and glucose and amino acids, but up to the present, it is used widely with clinical experience of more than 15 years. Therefore, it might be reasonable to ensure that its efficacy and safety is confirmed. The physicians have reported that it contributes to the convenient and efficient nutrition therapy, allowing enhanced patient compliance and convenience at hospital. In addition, depending on the further R&D works, 3-chamber bags are expected to advance further, opening a new landscape for advanced nutrition therapy.