Being told that you or a loved one need(s) Total Parenteral Nutrition (or TPN for short) can be a source of stress. TPN is designed to bypass the eating and digestive processes to bring nutrients directly to the bloodstream using intravenous nutrition feeding.
It is important to note that TPN can be administered to patients of all ages, including children. In the media and movies, IV nutrition is typically seen administered to comatose patients. However, there are many other scenarios in which a patient may require TPN.
Below, we explain what TPN is, how it works, how it is managed, and in which situations it is recommended.
TPN is the administration of nutrition through an IV method, ensuring nutrition enters the body through the veins rather than the traditional feeding method. Patients with TPN can receive a variety of nutrients, typically including protein, fat, minerals, carbohydrate, electrolytes, and vitamins. TPN typically combines the essential nutrients a patient needs within a solution of water. TPN solutions are customized to individual requirements, based on health data, patient's age, organ's functions, etc.
Total Parenteral Nutrition must be administered in a fully sterile and clean environment using a central venous catheter, which is a needle or a catheter placed into one of the large veins going to the heart. The central venous catheter remains in place. Patients on TPN receive IV feeding 5 to 7 days a week, for 10 to 12 hours each time, either during daytime or nighttime.
Parenteral Nutrition is designed to bypass the digestive system. Doctors recommend it for patients who don't have a functional gastrointestinal tract, either because the absorbing ability is compromised or because the tract is interrupted. It can also be used when complete bowel rest is required. Diseases, such as the following, require TPN:
Some patients may require TPN for different periods of time, ranging from temporary IV nutrition feeding to lifetime PN requirements. More often than not, patients who require long-term TPN can work with their doctors to arrange home-based therapy for convenience. According to the American Society for Parenteral and Enteral Nutrition, approximately 25,000 patients receive parenteral nutrition at home.
The purpose of TPN is to deliver essential nutrients to the body. Consequently, the TPN ingredients are carefully selected to meet each patient's individual nutrition needs.
As mentioned earlier, the medical history of the patient plays a significant role in the choice of ingredients. Indeed, a patient with kidney disorder is likely to receive less liquid in the TPN to prevent buildup in the bloodstream. On the other hand, some medical conditions, such as respiratory failure, will require a higher volume of liquid intake. Additionally, energy, vitamin, and mineral requirements also vary by age group.
The patient's progress is monitored closely by a medical and nutrition team. For TPN administered in a hospital or care center environment, the specialist team is present within the healthcare establishment and responsible for:
For home TPN administration, it's essential for the patient and medical team to work hand-in-hand. Doctors work in conjunction with a home infusion company and lab results to ensure TPN doses are adapted to the nutrition requirements of each patient.
A patient receiving TPN at home is under constant monitoring of an interdisciplinary nutrition and medical team that takes frequent measurements of:
Patients also receive the support of a qualified home nurse to be trained in the correct administration method and prevent risks of infection. The patient becomes responsible for some steps of the TPN process:
Without appropriate follow-up and monitoring, patients with TPN could develop serious health complications, such as liver dysfunction, glucose anomalies, and catheter-induced sepsis. Some complications can be reversed or prevented through health monitoring and medical management with an expert team.
Total Parenteral Nutrition can significantly transform the quality of life for patients with long-term conditions that affect the safe absorption of nutrients through the gastrointestinal tract. Home TPN can protect patients' independence and flexibility but requires diligent monitoring, appropriate administration care, and dedicated customized doses.
Please contact the Kidney360 team if you wish to have more information regarding TPN management.
