Intravenous Nutrition

Question 1

What are the indications for total parenteral nutrition (TPN)?

Answer 1

Preparation of undernourished patients for surgery, chemotherapy, or radiation therapy
Severe or prolonged disorders of the gastro-intestinal tract
Major surgery
Trauma
Burns
Prolonged coma
Refusal to eat

Question 2

What does the solution used in parenteral feeding contain?

Answer 2

Amino acids 
Glucose 
Fat 
Electrolytes 
Trace elements 
Vitamins

Question 3

What vitamins are given with parenteral feeding?

Answer 3

A single dose of B12 by IM
(regular injections are not required unless total TPN continues for months)

Folic acid 15 mg once or twice a week

Other vitamins are usually given daily, given in the TPN solution.

Question 4

How can TPN be given?

Answer 4

• Central venous catheter

- Peripheral vein may be used for supplementary as well as total parenteral nutrition

Question 5

What are the complications of long-term parenteral nutrition?

Answer 5

Gall bladder
Gall stones
Cholestasis
Abnormal liver function tests

Question 6

Why is it necessary to provide adequate phosphate in parenteral nutrition regimens?

Answer 6

To allow phosphorylation of glucose and to prevent hypophosphataemia

Question 7

What can be used to to attempt to avoid the problem of hyperosmolar hyperglycaemic non-ketotic acidosis?

Answer 7

Fructose and sorbitol

Question 8

When is Selenium deficiency likely to occur?

Answer 8

Inadequate diet or prolonged parenteral nutrition.

A Selenium supplement can be given