Total parenteral nutrition (TPN)

Total Parenteral Nutrition is defined as the provision of all nutritional requirements, without the use of gastrointestinal tract. It is employed when there is intestinal failure i.e. 'A reduction in the functioning gut mass below the minimal necessary for adequate digestion and absorption of nutrients.'

Indications for total parenteral nutrition

1- Absolute Indications

   Proximal entercutaneous fistulae

2- Relative Indications

  Moderate or severe malnutrition.

  Severe Inflammatory bowel disease.

  Severe Pancreatitis

  Prolonged ileus

  Abdominal sepsis.

  Major trauma and burns

  Massive intestinal resection (particularly if <100 cm of small bowel remians)

Contraindications for TPN

  Congestive cardiac failure

  blood dyscariasis

  uncontrolled diabetis mellitus

  fat metabolism disturbance

  liver failure

Infraclavicular subclavian line