Archive:Total parenteral nutrition

Total parenteral nutrition (TPN) is the practice of feeding a patient without using their gut. It is normally used during surgical recoveries. It has been used for patients in coma, although enteric (tube) feeding is usually adequate, and less prone to complications. Chronic TPN is occasionally used treat people suffering the extended consequences of an accident or surgery. Most controversially, TPN has extended the life of a small number of children born with nonexistent or severely birth-deformed guts. The oldest have reached the age of 8, as of 2003.

In 2003, the standard method of performing TPN is with a medical infusion pump. A sterile bag of nutrient solution, between 500ml and 4l is provided. The pump infuses a small amount (0.1 to 10ml/hr) continuously in order to keep the vein open. Feeding schedules vary, but a normal regimen ramps up the nutrition over a few bours, levels off the rate for a few hours, and then ramps it down over few more hours, in order to simulate a normal set of meal times.

Battery-powered ambulatory infusion pumps are used with chronic TPN patients, and usually the pump and a small bag of nutrient to keep the vein open are carried in a fanny pack. Outpatient TPN practices are still being refined.