Administration of TPN

Administration of TPN

Klek, S., & Kapala, A. (2018). Nutritional treatment. Oncology in Clinical Practice, 14(4), 216–225.

In this article, Klek and Kapala (2018) discuss the nutritional treatment of patients suffering from cachexia syndrome or cancer cachexia. This disease is characterized by weight loss, reduced protein concentration, weak intestinal motility, and digestive disorders and malabsorption, which hinder the application of nutritional therapy via the gastrointestinal tract, thus calling for the adoption of total parenteral nutrition (TPN). The administration of TPN can be conducted using a catheter whose tip is positioned in a central vain, arteriovenous fistula, a cannula inserted into the peripheral vein, and avascular port implanted under the chest. Moreover, the authors of the article recommend the inclusion of all nutrients when using this approach. As such, this article is vital in that it provides comprehensive information on how TPN is administered.

Hammad, A., Kaido, T., Aliyev, V., Mandato, C., & Uemoto, S. (2017). Nutritional therapy in liver transplantation. Nutrients, 9(1126).

In this publication, Hammad, Kaido, Aliyev, Mandato, and Uemoto (2017) argue that protein-energy dietary deficiency is prevalent among individuals experiencing end-stage liver illness who undertake liver transplantation. While oral nutrition is preferred, the condition of the patients necessitates the need for the application of total parenteral nutrition (TPN) to address the nutritional requirements of these patients. In the administration of TPN, numerous enteral nutrition compositions offer a broad scope of lipid prescriptions from various sources for fatty acids. In the prescription of total parenteral nutrition, a majority of health organizations combine “three-in-one” TPN compositions, which have amino acids, lipids, and dextrose.

Increasingly dilute formulations lack stability when there are hypertonic dextrose and amino acids, leading to the dissociation of the lipid admixture into oil and water. From the evidence provided, this article provides critical insight regarding the prescription and combination of TPN solutions.

Parra-Flores, M., Souza-Gallardo, L. M., Garcia-Correa, G. A., & Centellas-Hinojosa, S. (2017). Incidence of infection associated with central venous catheter and related risk factors in patients on total parenteral nutrition in a third level hospital. CIRUGIA Y CIRUJANOS, 85(2), 104-108.

In this investigation, Parra-Flores, Souza-Gallardo, Garcia-Correa, and Centellas-Hinojosa (2017) sought to identify the prevalence and risk elements linked with catheter-associated infection in sick persons on total parenteral nutrition (TPN). Complications, which involve infections in the central line access, are attributed to be a substantial cause of high morbidity and mortality among patients admitted in hospitals. In this backdrop, the findings of the study established that the utilization of TPN enhances the likelihood of infection-related with a catheter because it is a possible avenue of culture. As such, the findings of the article provide useful information concerning the increased risk of catheter infection under the administration of TPN.

Hartman, C., Shamir, R., Simchowitz, V., Lohner, S., Cai, W., & Decsi, T. (2018). ESPGHAN/ESPEN/ESPR guidelines on pediatric parenteral nutrition: Complications. Clinical Nutrition, 30, 1-12.

In this article, the authors address the areas where complications during the administration of total parenteral nutrition emerge. These areas include CVC associated complications, such as infection, pulmonary thrombosis, accidental removal, and pulmonary embolism. In particular, the use of TPN, as well as the duration of its use, heightens the risk of catheter-associated bloodstream infection. The study also discusses the complexities and cogitations associated with the constitution of TPN. Typically, the authors suggest that the administration of TPN should be done using an admixture composition, which has received the approval of a licensed manufacturer. The authors also consider metabolic complications of TPN and drug compatibility. In this backdrop, the article offers critical information concerning the considerations for the administration of TPN.

Patel, P., & Bhatia, J. (2017). Total parenteral nutrition for the very low birth weight infant. Seminars in Fetal and Neonatal Medicine, 22(1), 2-7.

In this study, the authors discuss the importance of administering total parenteral nutrition among preterm infants, particularly those with low birth weight. Preterm newborns with increasingly low birth weight have a heightened vulnerability to growth difficulties in postnatal life if nutritional requirements remain unaddressed. Bad postpartum growth among preterm newborns is attributed to causing undesirable neurodevelopmental outgrowths during childhood. For this reason, early administration of TPN is increasingly critical to offer desirable protein and energy to infants with low birth weight when the use of enteral nutrition is undesirable. As such, the article provides crucial information regarding the importance of the administration of total parenteral administration, particularly among preterm infants with low birth weight.