Parenteral Nutrition 2

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Parenteral nutrition


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Parenteral nutrition

• Parenteral nutrition (PN) isfeeding a person intravenously,

bypassing the usual process ofeating and digestion. The personreceives nutritional formulae that

contain nutrients such as glucose,amino acids, lipids and addedvitamins and dietary minerals.


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• called total parenteral nutrition(TPN) or total nutrient admixture

(TNA) hen no signi!cantnutrition is obtained by otherroutes.


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• called peripheral parenteral nutrition

(PPN) when administered through vein

access in a limb, rather than through a

central vein.


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"istory

• #eveloped in the $%&'s by #r tanley .#udric*, ho as a surgical resident in the+niversity of Pennsylvania, or*ing in the

basic science laboratory of #r onathanhoads, as the !rst to successfully nourishinitially -eagle puppies and subseuentlyneborn babies ith catastrophic

gastrointestinal malignancies./$0 #r #udric*collaborated ith #r 1illmore and #r 2ars tocomplete the or* necessary to ma*e thisnutritional techniue safe and successful.


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complication

• -lood clots

• 3hronic 42 access leaves a foreign

body in the vascular system, andblood clots on this 42 line arecommon.#eath can result frompulmonary embolism herein a clot

that starts on the 42 line but brea*so5 goes into the lungs


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• 6atty liver and liver failure• 6atty liver is usually a more long

term complication of TPN, though

over a long enough course it is fairlycommon. The pathogenesis is due tousing linoleic acid (an omega7& fatty

acid component of soybean oil) as ama8or source of calories.


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• "unger

• -ecause patients are being fedintravenously, the sub8ect does notphysically eat, resulting in intense

hunger pangs. The brain uses signalsfrom the mouth (taste and smell), thestomach9:.4. Tract (fullness) andblood (nutrient levels) to determineconscious feelings of hunger.


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• 3holecystitis

• Total parenteral nutrition increasesthe ris* of acute cholecystitis due tocomplete disuse of gastrointestinaltract, hich may result in bile stasisin the gallbladder. ;ther potential

hepatobiliary dysfunctions includesteatosis,steatohepatitis, cholestasis,and cholelithiasis


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• :ut atrophy.

• 4nfants ho are sustained on TPNithout food by mouth for prolongedperiods are at ris* for developing gutatrophy


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other complication

• Catheter complications include

pneumothorax, accidental arterial

puncture, and catheter-related sepsis.


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other complication

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Parenteral Nutrition 2

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