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Total Parenteral Nutrition (TPN) - Total Parenteral Nutrition Price
TPN is used when individuals cannot or should not get their nutrition through eating. TPN is used when the intestines are obstructed, when the small intestine is not absorbing nutrients properly, or a gastrointestinal fistula (abnormal connection) is present. It is also used when the bowels need to rest and not have any food passing through them. Bowel rest may be necessary in Crohn's disease, pancreatitis, ulcerative colitis, and with prolonged bouts of diarrhea in young children. TPN is also used for individuals with severe burns, multiple fractures, and in malnourished individuals to prepare them for major surgery, chemotherapy, or radiation treatment. Individuals with AIDS or widespread infection (sepsis) may also benefit from TPN. It is also used for patients who have gastroparesis and cannot digest food properly. Description: TPN is normally given through a large central vein. A catheter is inserted into the vein in the chest area under local anesthesia and sterile conditions. Often the placement is done in an operating room to decrease the chance of infection. Several different types catheters are used based on the reason TPN is needed and the expected length of treatment. Once the catheter is in place, a chest x ray is done to make sure the placement is correct. Normally TPN is administered in a hospital, but under certain conditions and with proper patient and caregiver education, it may also be used at home for long-term therapy. TPN solution is mixed daily under sterile conditions. Maintaining sterility is essential for preventing infection. For this reason, the outside tubing leading from the bag of solution to the catheter is changed daily, and special dressings covering the catheter are changed every other day. What the solution contains: The contents of the TPN solution are determined based on the age, weight, height, and the medical condition of the individual. All solutions contain sugar (dextrose) for energy and protein (amino acids). Fats (lipids) may also be added to the solution. Electrolytes such as potassium, sodium, calcium, magnesium, chloride, and phosphate are also included, as these are essential to the normal functioning of the body. Trace elements such as zinc, copper, manganese and chromium are also needed. Vitamins can be included in the TPN solution, and insulin, a hormone that helps the body use sugar, may need to be added. Adults need approximately 2 liters of TPN solution daily, although this amount varies with the age, size, and health of the individual. Special solutions have been developed for individuals with reduced liver and kidney function. Successful TPN requires frequent, often daily monitoring of the individual's weight, glucose (blood sugar) level, blood count, blood gasses, fluid balance, urine output, waste products in the blood (plasma urea) and electrolytes. Liver and kidney function tests may also be performed. The contents of the solution are individualized based on the results of these tests.
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How to prepare and administer TPN
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