TPN Therapy & Treatment

Instructor: Sheila Bouie
This lesson will explain total parenteral nutrition (TPN) and discuss when this therapy is used. Learn to identify patients for whom TPN is appropriate, and common complications of the therapy.

What Is Total Parenteral Nutrition?

Let's say an old home needs some plumbing work before the new owners can move in, as all of the original pipes are lined with a corrosive material. They hire contractors who decide to treat them with a new material that needs to sit within the pipes for weeks to cure before use.

In the meantime, they add a temporary diversion from the house's main pipeline to the outside mainline. Great! This plan allowed the homeowners to continue to live in the old house until the old pipes were ready.

Now let's switch gears. Suppose your intestinal tract were like these old pipes - they did not function properly and you were unable to digest food. It could be related to disease or surgery or even a temporary injury. How would you maintain your nutritional level? There must be a way to get your body the nutrition it needs and bypass the digestive system.

This is where total parenteral nutrition (TPN) comes in. Total parenteral nutrition is a therapy that supplies your body with all of the nutrients and vitamins the body needs to sustain and/or heal. 'Parenteral' means outside your normal digestive route (mouth to stomach to intestines to colon).

For patients who require this life saving treatment, total parenteral nutrition is the alternate route necessary to allow patients to maintain energy and sustain life, much like the plumbing re-route in the old house.

How Is TPN Administered?

Total parenteral nutrition therapy uses a bag of fluid that slowly administered directly into your veins. Each bag has a highly concentrated solution containing vitamins, electrolytes, carbohydrates, and more. Treatments are individualized meaning the solution is formulated to meet the nutrition needs of the recipient.

Because of the high concentration of contents, total parenteral nutrition cannot be given through small veins like regular intravenous (IV) solutions. Instead, it's delivered through a special IV route using a central catheter inserted into a large blood vessel like the superior vena cava (a vein that carries deoxygenated blood into the heart).

The catheter for TPN is often inserted into the superior vena cava, in blue at top left.
vena cava

Therapy Vs Treatment

Just so we don't confuse matters, we should distinguish between therapy and treatments.

  • Therapy is a treatment or session intended to alleviate a problem; it includes treatments and is a more comprehensive term.
  • Treatment is the specific act of administering or applying something to relieve or alleviate a problem.

When we talk about total parenteral nutrition, each bag of solution is a treatment, and the course of receiving the TPN is nutritional therapy.

Criteria and Risks

Total parenteral nutrition is used in various cases where the intestinal tract is either impaired or requires a rest to heal. Therapy can be a short-term event or long-term therapy. There are no age restrictions on who can receive it, but some inclusion criteria are disease process, inability to take or absorb food by mouth, or a need for nutrients above what can be supplied by tube feedings.

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