parenteral nutrition


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parenteral

 [pah-ren´ter-al]
by some route other than through the alimentary canal, such as by subcutaneous, intramuscular, intrasternal, or intravenous injection.
parenteral nutrition a technique for meeting a patient's nutritional needs by means of intravenous feedings; sometimes called hyperalimentation, even though it does not provide excessive amounts of nutrients. Nutrition by intravenous feeding may be either total parenteral nutrition or only supplemental.

Total parenteral nutrition provides all of the carbohydrates, proteins, fats, water, electrolytes, vitamins, and minerals needed for the building of tissue, expenditure of energy, and other physiologic activities. The procedure originated as an emergency life-saving technique following surgery for severe and massive trauma of the gastrointestinal tract but has now become a relatively common means of providing bowel rest and nutrition in a variety of conditions in spite of inherent risks. Although primarily used as a short-term temporary measure until either surgical or medical treatment corrects the gastrointestinal dysfunction, it has also been used with some success as a long-term therapy for selected patients on an outpatient basis.

Parenteral nutrition may be used in the following conditions: malnutrition from such acute and chronic inflammatory bowel diseases as regional ileitis (crohn's disease) and ulcerative colitis, partial or total obstruction of the gastrointestinal tract that cannot be relieved immediately by surgery, congenital anomalies in the newborn prior to surgery, massive burns that produce critical protein loss, and other disorders in which malnutrition is a threat to the life of the patient who cannot receive nutrients via the digestive tract.

The nutrient mix is tailored to the individual needs and tolerance of the patient. There is not complete agreement among the experts as to the ideal mix, especially of amino acids. The nutrient solutions usually are prepared in clean-air rooms in the pharmacy of a hospital under aseptic conditions to avoid contamination.

Administration of the nutrients is accomplished via a central venous catheter, usually inserted in the superior vena cava. The route of administration, constant rate of flow required, and potential patient sensitivity to the elements administered, all contribute to the potential complications of parenteral nutrition.

Of the many complications that may develop, the most common are febrile reactions arising from patient intolerance to the required rate of flow, reactions due to individual sensitivity to some of the elements in the nutrient mix, and infection from contamination of either the site of insertion of the catheter or the apparatus used to administer the nutrients. Other complications that may develop include phlebitis and thrombosis of the vena cava, electrolyte imbalance, hyperglycemia, cardiac overload, dehydration, metabolic acidosis, and mechanical trauma to the heart.
Patient Care. Principles of strict aseptic technique must be followed in the daily changing of dressings and in handling the nutrient solution and the administration equipment. The catheter through which the nutrients are administered should not be used for administration of medication, blood, or any other substance that may induce clotting in the vein.
Superior vena cava administration of parenteral nutrition through a subclavian venous line. From Lammon et al., 1996.

parenteral nutrition

the administration of nutrients by a route other than the alimentary canal, such as subcutaneously, intravenously, intramuscularly, or intradermally. The nutrients, or parenteral fluids, usually consist of physiological saline solution with glucose, amino acids, electrolytes, vitamins, and medications. They may not be nutritionally complete but maintain fluid and electrolyte balance during the immediate postoperative period and in other conditions, such as shock, coma, malnutrition, and chronic renal and hepatic failures. See also total parenteral nutrition.

parenteral nutrition

IV feeding, parenteral alimentation The administration of nutrients parenterally, usually IV. See Total parenteral nutrition. Cf Forced feeding.

pa·ren·ter·al nu·tri·tion

(PN) (pă-ren'tĕr-ăl nū-trish'ŭn)
Providing the body with nutrition intravenously.
Synonym(s): intravenous alimentation.

parenteral nutrition

Intravenous feeding. This is required when the normal (enteral) route cannot be used. Early attempts at intravenous feeding via peripheral veins invariably led to severe THROMBOPHLEBITIS within a matter of hours because of the strong sugar solutions used. A central venous cannula had therefore to be used. Developments in design of cannulas and new feeding solutions, with calorie-rich lipids in place of strong sugar concentrations, amino acids and weaker carbohydrates may, it is hoped, allow safe peripheral vein feeding.

Parenteral nutrition

Nutrition supplied intravenously, thus bypassing the patient's digestive tract entirely.

pa·ren·ter·al nu·tri·tion

(PN) (pă-ren'tĕr-ăl nū-trish'ŭn)
Providing the body with nutrition intravenously.
Synonym(s): intravenous alimentation.

nutrition

1. the sum of the processes involved in taking in nutriments and assimilating and utilizing them.
2. nutriment.
It includes all the processes by which the body uses food for energy, maintenance and growth. See also malnutrition, inanition, starvation, thirst, nutritional.

critical care nutrition
provision of nutritional support for patients in critical care units; usually requires modification of normal nutritional requirements to meet the demands of stress, injury and disease, and to support recovery from these states.
enteral nutrition
see enteral feeding.
intravenous nutrition
see parenteral nutrition (below).
nutrition Labeling and Education Act of 1990
an amendment to the (US) Federal Food, Drug, and Cosmetic Act which defines how foods, claimed to affect disease, are not regulated as drugs.
parenteral nutrition
a technique for meeting a patient's nutritional needs by means of intravenous feeding; sometimes called hyperalimentation, even though it does not provide excessive amounts of nutrients. Nutrition by intravenous feeding may be total parenteral nutrition (TPN) or supplemental. TPN provides all of the carbohydrates, proteins, fats, water, electrolytes, vitamins and minerals needed for the building of tissue, expenditure of energy, and other physiological activities.
total parenteral nutrition
called also TPN; see parenteral nutrition (above).

parenteral

not through the alimentary canal, e.g. by subcutaneous, intramuscular, intrasternal or intravenous injection, e.g. parenteral fluid therapy.

parenteral alimentation
see parenteral nutrition (below).
parenteral hyperalimentation
see parenteral nutrition (below).
parenteral nutrition
the provision of adequate carbohydrate, protein, vitamins, minerals and fluids parenterally to maintain the animal over a relatively long period of several weeks. Called also parenteral alimentation, parenteral hyperalimentation. See also parenteral nutrition.
parenteral therapy
treatment by the parenteral route is limited to those substances that are soluble in a solvent that can be injected into tissues including the bloodstream. The choice of routes may depend on the nature of the vehicle used, e.g. oily preparations are injected into tissues, irritant substances are injected intravenously slowly.

Patient discussion about parenteral nutrition

Q. why is it that some women lack parental nutrition?

A. Do you mean breastfeeding? Some women have problem with their nipples, in rare cases the breast tissue isn't developed enough. Sometimes breast surgeries damage the milk ducts. Psychological factors also play a role.

More discussions about parenteral nutrition
References in periodicals archive ?
This outbreak highlights the importance of LM as an emerging hospital pathogen in patients with underlying diseases and in whom parenteral nutrition may be the source of the initial infection and its spread.
Carnitine deficiency with hyperbilirubinemia, generalised skeletal muscle weakness and reactive hypoglycemia in a patient on long-term parenteral nutrition.
The proportion of patients treated with teduglutide who achieved a 20% to 100% reduction of parenteral nutrition at Week 20 and 24 was significantly higher compared with those receiving placebo, (63% versus 30%, p=0.
Dr Kamal Osman Hassan, paediatric gastroenterology senior consultant and head of the Paediatric Gastroenterology Section at Hamad General Hospital (HGH), explained that prior to the new homecare service, patients requiring parenteral nutrition were required to spend a significant amount of their time at the hospital.
Teduglutide represents an important treatment advance that could significantly reduce or even eliminate parenteral nutrition support for patients with short bowel syndrome.
These infants rely on long term parenteral nutrition support that puts them at risk of liver disease, line infections and other complications.
Many preterm infants rely on IV nutrition, also known as parenteral nutrition (PN), at birth to meet all or part of their daily nutritional requirements.
Newly updated with base year data for 2014, Clinical Nutrition Products: A Worldwide Perspective is a Kalorama Information report that focuses on three primary segments of essential medical nutrition: Infant Nutrition (Milk-based, Soy-based, Elemental, Follow-Up, Organic, Probiotic / Prebiotic, Premature, Newborn and Other Specialized Formulas) Enteral Nutrition (Standard and Fiber-containing Elemental and Semi-elemental, Specialized for Chronically Ill Patients) Parenteral Nutrition (indicated for a variety of disorders including Gastrointestinal Disease, Burns, Extensive Wounds, Cancer, AIDS)Information is presented as a worldwide overview, with special emphasis on the U.
Recent safety concerns in the preparation and delivery of parenteral nutrition (PN), commonly referred to as intravenous (IV) nutrition, prompted leaders from several major organizations to participate in a PN Safety Summit on September 23, 2011.
NEW YORK, March 18, 2015 /PRNewswire/ -- This report analyzes the worldwide markets for Parenteral Nutrition in US$ Million.
The poster authors concluded that the use of a disinfection cap on central venous catheters may lower CLABSI risk for parenteral nutrition patients and multi-lumen catheter patients, who are more vulnerable to catheter infections.