Total parenteral nutrition (TPN) is a method of feeding that bypasses the gastrointestinal tract. Fluids are given into a vein. This provides most of the nutrients the body needs. The method is used when a person cannot or should not receive feedings or fluids by mouth.
Sick or premature newborns may be given TPN before starting other feedings. They may also have this type of feeding when they cannot absorb nutrients through the gastrointestinal tract for a long time. TPN delivers a mixture of fluid, electrolytes, calories, amino acids, vitamins, minerals, and often fats into an infant's vein. TPN can be lifesaving for very small or very sick babies. It can provide a better level of nutrition than regular intravenous (IV) feedings, which provide only sugars and salts.
Infants who get this type of feeding must be checked to make sure they are getting the proper nutrition. Blood and urine tests help can the health care team know what changes are needed.
HOW IS TPN GIVEN?
An IV line is often placed in a vein in the baby’s hand, foot, or scalp. A large vein in the belly button (umbilical vein) may be used. Sometimes a longer IV, called a central line or peripherally-inserted central catheter (PICC) line, is used for long-term IV feedings.
WHAT ARE THE RISKS?
TPN is a major benefit for babies who cannot get nutrition other ways. However, this type of feeding can result in blood sugars, fats, or electrolytes that are too low or too high.
Problems can develop due to use of the TPN or IV lines. The line may move out of place or clots may form. A serious infection called sepsis is a possible complication of a central line IV. Infants who receive TPN will be checked often by the health care team.
Long-term use of TPN may lead to liver problems.
American Society for Parenteral and Enteral Nutrition - Professional Association. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. JPEN J Parenter Enteral Nutr. Jan-Feb 2002;26(1 Suppl): 1SA-6SA.
American Society for Parenteral and Enteral Nutrition - Professional Association. Normal requirements - pediatrics. JPEN J Parenter Enteral Nutr. Jan-Feb 2002;26(1 Suppl):25SA-32SA.
Parenteral nutrition. In: Pediatric Nutrition Handbook. 6th ed. Elk Grove Village, IL: American Academy of Pediatrics; 2009; chap 22.
Sameer Patel, MD, Assistant Professor of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, Il. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Bethanne Black, and the A.D.A.M. Editorial team.