PARENTERAL NUTRITION

lipids and added vitamins .Definition Sir Christopher Wren in 1658 is feeding a person intravenously. glucose. bypassing the usual process of eating and digestion The person receives nutritional formulas that contain nutrients such as salts. amino acids.

and for GI recovery .Types of parenteral nutrition – Partial parenteral nutrition (PPN) is indicated for clients who can meet some of their nutritional requirements orally (i.e. clients with severe and extensive burns or other trauma. shortened small bowel due to injury/disease) – Total parenteral nutrition (TPN) is required for severely malnourished clients.

Indication • a patient is severely undernourished. • a patient suffers from chronic diarrhea and vomiting. and needs to have surgery. • a patient's (their "gastrointestinal tract") is paralysed. radiotherapy or chemotherapy. • Bowel obstruction • Patients with inability to absorb nutrients via GI tract . • a baby's gut is too immature. for example after major surgery.

capable of absorption of adequate nutrients • When sole dependence on TPN is anticipated to be less than 5 days • Inability to obtain venous access • A prognosis that does not warrant aggressive nutritional support .When NOT to use • Patients who have a functional and usable GI tract.

Routes • Umbilical vein (upto day 7) • Peripheral vein • Central vein .

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Composition in pre-digested form • • • • • • Protein as amino acids Fat as lipid emulsion Carbohydrates as dextrose Multivitamins electrolytes Trace elements .

0 mg* 0.15 – 0.0 – 15.8 mg Electrolytes Potassium Sodium Phosphorus Magnesium Calcium Chloride .0 m g 0.5 – 1.Vitamin Vitamin A Vitamin D Vitamin E Ascorbic acid Folacin Niacin Riboflavin Thiamin B6 (pyridoxine) B12 (cyanocobalamin) Pantothenic acid Biotin Mineral Zinc Copper Chromium Magnesium Amount 3.300 IU 200 IU 10 IU 100 mg 400 m g 40 mg 3.5 mg 10.6 mg 3 mg 4 mg 5mg 15 mg 60 m g Amount 2.5 – 4.

Medications That May Be Added • • • • • Phytomenadione Selenium Zinc chloride Levocarnitine Insulin • • • • • Metoclopromide Ranitidine Sodium iodide Heparin Octreotide .

Complications METABOLIC CATHETER/PUMP COMPLICATIONS •Infection •Hyperglycemia •Hypoglycemia •Dehydration •Liver failure •Priapism •Air embolism •Blood in catheter •Catheter tear •Catheter clot •Phlebitis •accidental arterial puncture .

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