What is Parenteral Nutrition?
- How is it done?
- What are the benefits?
- What are the risks?
Parenteral nutrition (PN) is an intravenous feeding method, bypassing the digestive tract. Patients receiving PN must be monitored closely for changes in medical status, fluid balance and weight fluctuations.
Nurses and other trained healthcare providers administer and monitor PN in hospitals, long-term care facilities or homes, adhering to stringent sterile standards to avoid infections at catheter sites.
How is it done?
Parenteral nutrition involves administering nutrients through an intravenous catheter placed near the heart. Alternatively, smaller veins farther from it may also be used (peripheral line).
Nutrient solutions contain dextrose, lipids, amino acids, electrolytes and multivitamins for your child to receive sufficient calories for healthy development. Therefore, the PN should contain carbohydrates, fat and protein; exactly how much of each will depend on his or her needs.
Your child’s healthcare team will assist in choosing an PN formula tailored specifically to them and your home environment, and then trained health care providers will educate both you and your family to prepare, administer and monitor it in-home.
PN can either be administered temporarily while waiting for your child to recover enough to return to oral or tube feeding, or permanently as part of their treatment plan. If it’s used as a temporary measure, our team will work closely with you in gradually reducing its dosage over time.
Before initiating a parenteral nutrition program, your doctor will check both blood pressure and blood sugar, administer an injection to protect from infection at entry and exit points of central venous catheter placement, check kidney and liver health as well as the body fluid balance.
Your instructor will show you how to clean, dress, and change the dressing at least once daily on the incision site. In addition, you’ll learn to inspect and clean any tubing connecting catheter to infusion bag before using a special pump to infuse nutrients directly into your child’s veins at night when sleeping.
At home, it is crucial that sterile practices be observed at all times when administering parenteral nutrition (PN). Furthermore, you should safeguard your child from contact with people carrying contagious diseases like Hepatitis C or HIV.
Parents can help their other children cope with having one sibling on a life-long regimen of PNS by scheduling “special time” with each of them to minimize any feelings of resentment or alienation. Assuring your child that they are loved and not being treated differently because of their condition will ensure they remain positive and hopeful for the future. If they experience discomfort or mouth sores, consult a healthcare provider immediately so they can offer advice or refer you to an expert for evaluation.
What are the benefits?
Parenteral nutrition, commonly referred to as TPN or PN, supplies all the body’s required vitamins and calories through large veins close to the heart, usually through an IV central line placed in either an upper arm vein, chest vein or neck vein. Parenteral nutrition may be administered at hospitals, long-term care facilities or even from home; however healthcare providers must adhere to stringent sterile practices to avoid infection at catheter sites or tubes.
PN can offer a complete diet of carbohydrates, proteins, fats, minerals and electrolytes, vitamins and trace elements tailored specifically to each patient’s nutritional requirements and tolerances. It may be used temporarily or become necessary as the sole source of nutrition indefinitely.
In most cases, those requiring this method of feeding will begin by starting with clear liquids, before gradually transitioning to full liquid diets and solid food diets over time. Their healthcare team will regularly reassess their nutritional requirements to make sure they’re getting enough fluid and energy to remain healthy.
The human digestive tract normally absorbs most of the calories and nutrients consumed through food, however in cases such as severe diarrhea due to illness or surgery, radiation enteritis, neurological disorders or other causes this process doesn’t always work effectively requiring total parenteral nutrition or partial parenteral nutrition as an alternative method for providing necessary calories and nutrition.
Bloodstream nutrition delivers all of the necessary vitamins and calories directly into the bloodstream; this differs from enteral nutrition which is given through the intestinal tract.
A key advantage of PN is its rapid delivery. The solution can be pumped directly into the bloodstream using a drip. Amino acids in this formula contribute 4 kcal per gram; in addition to providing energy, they act as building blocks of proteins used for essential bodily processes.
Risks associated with IV nutrition include infection at the catheter site, blood clots or mineral imbalances affecting electrolytes and blood sugar metabolism. Therefore, healthcare teams regularly check blood for any indications of infections or any serious complications, changing dressings at incision sites as needed and cleaning tubing connecting catheter to infusion bag daily.
What are the risks?
Parenteral nutrition (PN) delivers all of the calories and nutrients your body requires daily through an IV rather than eating food directly. This includes proteins, carbohydrates, fats, minerals and electrolytes, vitamins and trace elements. PN may be administered via central vein in neck or chest with catheter directly leading to heart, or through peripheral veins such as arm or leg veins. Your health care team will monitor you closely to make sure you’re receiving all the calories and nutrients that your body requires; laboratory tests may be run periodically to monitor kidney and intestinal performance while checking blood vessels or catheter issues in case any problems arise with catheter placement or blood vessel issues arise that require attention.
Your health care team will explain all that’s involved and help you determine whether it would benefit your recovery process. They may even instruct either yourself or caregivers how to administer it at home – depending on why PN may be necessary.
Long-term PN therapy may be prescribed for people suffering from severe malabsorption or motility disorders in their intestines or stomach, as well as premature infants who lack sufficient body stores of fat and muscle mass for growth and development. Furthermore, cancer patients experiencing oral feeding issues like mucositis, stomatitis or esophagitis may benefit from long-term PN therapy as it aids their oral intake.
Infections of the lines through which PN is delivered pose a significant threat and may require treatment with antibiotics, suspending PN delivery or even removal of the line altogether. Additional complications can include too much or too little energy being provided as well as mineral/electrophile imbalances and liver disease.
Long-term exposure to PN can have long-term repercussions, including bone demineralization (osteomalacia) and vitamin deficiencies. Furthermore, those using it for more than five years may develop something called “peritoneal nutrition-associated liver disease”, similar to chronic liver failure. Although its exact cause remains unknown, it could be related to the loss of healthy gut bacteria caused by prolonged use.
Some studies have indicated that parenteral nutrition (PN) increases the risk of infections in intensive care units; however, one large study concluded no difference in death or major complications between patients who received PN and those who didn’t, supported by smaller studies of life-threatening conditions. Patients requiring prolonged PN can learn how to administer it themselves at home under close monitoring by their healthcare providers.