Sometimes, for a variety of different reasons, a person is unable to get a healthy level of nutrition by taking in food through his or her intestines. Total parenteral nutrition (TPN) is the standard therapy for people who have this problem. TPN can be used to treat a severe disorder that is expected to last for a relatively short time, such as intractable vomiting during pregnancy. It is also used as a long-term therapy.
With total parenteral nutrition, a solution of essential nutrients (including proteins, fluids, electrolytes, and fat-soluble vitamins) is given into the veins (intravenously). Because TPN solutions are highly concentrated and thick, the solutions must be given through catheters that are placed in large central veins in the neck, chest, or groin. An infusion pump controls the rate at which the TPN solution is given, so that the concentrated food does not overload other digestive organs. For many patients receiving TPN, the pump is portable.
About half of patients receiving TPN need long-term or permanent TPN therapy. Most patients who are on permanent TPN receive the therapy at home. Approximately 40,000 people in the United States are receiving TPN at home.
Complications of Total Parenteral Nutrition
Total parenteral nutrition gives many people without the use of their intestines a chance at long, productive lives. Still, patients receiving TPN are always at risk of complications from the procedure. Complications may include:
- Clotting (thrombosis) in central access veins
- Frequent infections in the central-vein access lines
- Inflammation of the gallbladder (cholecystitis)
- Bone disease (osteoporosis)
- TPN-induced liver damage or liver failure
- TPN-induced liver failure occurs more often in children than adults. Some people who receive long-term TPN may develop social problems because TPN can severely limit their everyday activities.
Survival Prospects of Total Parenteral Nutrition
The long-term survival prospects of patients maintained through total parenteral nutrition vary, depending on the cause of intestinal failure. Three-year survival of TPN-dependent patients ranges from 65 to 80 percent. For the 20 to 35 percent of patients who fare poorly on TPN, intestinal transplantation may be a life-saving procedure. Other patients who are successfully maintained by TPN may also benefit from an intestine transplant.
Learn more with our Frequently Asked Questions about TPN.
