Total parenteral nutrition (TPN)

Your doctor may prescribe total parenteral nutrition (TPN) if you have a condition in which your digestive system – your stomach, your small intestine or your large intestine – can’t handle food. TPN lets your digestive system rest while still providing the nutrients and fluid you need.

What is TPN?

TPN supplies fluid and nutrients in a solution that is infused through an IV into your bloodstream. The total parenteral nutrition solution contains fats, amino acids (protein), carbohydrates and other nutrients to keep you healthy and hydrated.

Total parenteral nutrition is often delivered through a port that is implanted just under the skin on the chest. A catheter is gently guided through veins to the large blood vessels around the heart. The port may be used for weeks or months to make it easier to give you total parenteral nutrition or medications.

Sometimes a port will be put in place on your arm. These ports are called peripherally inserted central catheters (PICC). Although the port is on the arm, a catheter will be inserted and carefully guided through the vein until it reaches the heart. That way, the TPN solution is delivered to the large blood vessels near the heart.

If you’re able to tolerate some food by mouth, you may receive another type of parenteral nutrition called partial parenteral nutrition.

No matter which type you receive, your doctor and other members of your health care team will be careful to balance the nutrients you’re receiving.

Enteral nutrition is another form of feeding through a catheter. Liquid enteral nutrition is delivered to the stomach or to the small intestine.

Total parenteral nutrition side effects

People who have total parenteral nutrition may develop infections that spread from the catheter or their digestive tract may shut down. Other potential side effects are:

• Blood clots where the catheter meets the vein
• Glucose or other nutrient imbalances
• Liver or gallbladder damage
• Bleeding

Conditions that may require total parenteral nutrition

Doctors may prescribe TPN for people who can’t swallow or digest food because of conditions such as these:

• Gastrointestinal disorders
  
• Chemotherapy side effects like nausea
• Certain cancers of the digestive tract
• Dysphagia (trouble with swallowing) following a stroke or other cerebrovascular accident
• Severe diarrhea or vomiting
• Post-surgical bowel rest needed
• Abdominal trauma
• Radiation enteritis (inflammation of the intestines)
• Premature birth

Short bowel syndrome

Short bowel syndrome is another condition for which doctors may prescribe total parenteral nutrition. This rare condition may be because of:

• Poor movement of food through the intestines
• Significant damage to the intestines
• Having had at least half of the small intestine removed
• Having had all or part of the large intestine removed