Total Parenteral Nutrition (TPN)

Last updated 20.09.12

 

Index

 

Definition

-   Provision of total nutritional needs via intravenous administration

 

Features

-   Monitoring guidelines

-  BSL 6/24

-  Week 1 of TPN

-   Daily: U&E, FBE, CMP (if risk of refeeding syndrome)

-   3/week: LFT, Transthyretin, CMP (if no risk refeeding syndrome)

-   Weekly: Iron studies, RBC folate, B12, Lipids, 24hr urine nitrogen balance, Zinc

-  Stable long term pt

-   3/week: U&E

-   Weekly: FBE, LFT, CMP, Lipids, Transthyretin

-   Every 2 weeks: Iron studies, RBC folate, B12, zinc, 24hr urine nitrogen balance

-   Monthly: Selenium, Manganese

-  Infusion rate calculated by Dietician based on energy requirements

-  Volume included in Fluid Balance Chart (FBC)

 

Content

-  Standard TPN in 2L

-  Nitrogen 16.5g

-  Protein 100g (16% of energy)

-  Glucose 250g (42% of energy)

-  Lipid 100g (42% of energy)

-  Total KJ 10032 (2400kcal)

-  Na 73mmol

-  K+ 60mmol

-  Mg 5mmol

-  Ca 0

-  Zinc 0

-  Cl 70mmol

-  Acetate 150mmol

-  PO4 37.5mmol

-  Standard TPN in 1L

-  Nitrogen 6.6g

-  Protein 40g (13% of energy)

-  Glucose 160g (54% of energy)

-  Lipid 40g (33% of energy)

-  Total KJ 5016 (1200kcal)

-  Na 32mmol

-  K+ 24mmol

-  Mg 2.2mmol

-  Ca 2

-  Zinc 0

-  Cl 48mmol

-  Acetate 57mmol

-  PO4 10mmol

-  TPN -K+, -Na,  -K+&Na, low PO4, low PO4 – Elec

-  Additions

-  Cernevit: multivitamins

-  MTECC: trace elements

-  MTEFE: trace elements with Iron & Selenium

 

Indications

-  Prematurity

-  Bowel rest post op

 

Complications

-  Elevated LFT due to high lipids