Total Parenteral Nutrition (TPN)

January 28, 2022
Janelle Thomas MSN, RN
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Certain conditions, particularly those affecting the gastrointestinal (GI) system, can require specialized nutritional needs. In medicine, total parenteral nutrition (TPN) is when all dietary needs in a patient are supplied by intravenous (IV) methods. This can ensure that people who are otherwise unable to ingest and digest regular food receive the nutrients and other requirements they need to live.

TPN is commonly used in pediatric care to meet the specialized care needs of young patients. If your child or the child of a loved one is undergoing or recommended to undergo, total parenteral nutrition, it is important for you to be as informed as possible. The following guide can help you learn more about the basics of TPN, including how it is administered and the potential risks you should be aware of.

Why use TPN?

By definition, parenteral refers to administering medication, hydration, or nutrition by a method other than the mouth, such as IV. Parenteral nutrition can be both partial and total and is used for patients with a variety of conditions and injuries. Partial parenteral nutrition can help patients who are temporarily incapacitated or have an illness or disease that inhibits the GI tract.

TPN supplies all daily nutritional requirements by IV and is only for patients with a completely nonfunctional GI system. The term total parenteral nutrition can refer to the practice of delivering nutrition and is also sometimes used to describe the liquid itself.  Any solution for TPN will contain all needed water, electrolytes, protein, fat, carbohydrates, and trace vitamins and minerals a child or adult needs to survive.

How is TPN administered?

In pediatrics, TPN can be administered for very sick newborns and children, including those with bowel obstructions, short bowel syndrome, and for many congenital GI disorders. Use can be short-term, long-term, or permanent, and TPN can be administered both in a hospital or at-home setting.

Steps for administration include:

  • Placing an IV line in the hand, foot, scalp, or other suitable location
  • For long-term feedings, a peripherally inserted central catheter (PICC) line may be needed
  • External tubing is changed every 24 hours
  • The line should not be used for any other purpose
  • Often, the transition to TPN will be gradual, starting at about half of the calculated requirements

To ensure that nutritional requirements are being met, the patient must be continually monitored and receive regular testing of weight, blood count, electrolytes, and nitrogen levels.

Potential TPN Side Effects, Risks, and Complications

TPN can be extremely beneficial and even life-saving for patients who need it, but there are associated risks, complications, and side effects.

Septic infection can be a primary concern, which is why the line must be continuously changed out and monitored every day.

Additionally, while the TPN solution is carefully calculated to meet nutritional needs, complications with blood sugar levels can develop due to patient differences. This is often addressed by using dextrose solutions.

Liver dysfunction and gallbladder dysfunction can also develop in many cases due to the body’s response to different mineral and vitamin levels in the solution, among other causes.

A central catheter is often required in long-term cases to prevent the formation of blood clots and thrombosis.

On a long-term basis, TPN can permanently alter the GI tract, so permanent TPN is usually only indicated for patients with little to no prospect of being able to feed themselves.

Contact Care Options for Kids for Home Health Care in Florida

It can be hard to balance your time between work, home, and caring for a child. That’s why our team of professionals at Care Options for Kids is here to help. We have been enforcing precautionary measures and following the Centers For Disease Control (CDC) guidelines for COVID-19 to ensure the safety and health of our clients and employees.

Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.

If you or a loved one are considering Pediatric Home Health Care Services in Florida, contact the caring staff at Care Options for Kids. Call today at (888) 592-5855.