Parenteral nutrition is the administration of nutrients through an intravenous route rather than through eating and digesting. Pharmaceutical compounding firms produce the goods. A formula-based nutritional mix containing glucose, salts, amino acids, lipids, vitamins, and dietary minerals is given to the individual. When no significant nutrition is obtained through other means, it is referred to as Total Parenteral Nutrition (TPN) or Total Nutrient Admixture (TNA), whereas when nutrition is also partially enteric, it is referred to as Partial Parenteral Nutrition (PPN). When it is given through a vein access in a limb rather than a central vein like Central Venous Nutrition (CVN), it is called Peripheral Parenteral Nutrition (PPN). When the gastrointestinal tract is unable to function due to a disruption in its continuity (such as a blockage, leak, or fistula) or impairment in its absorptive capacity, Total Parenteral Nutrition (TPN) is administered. Although enteral feeding is typically preferred and less prone to complications, it has been used for comatose patients. In patients who are unable to obtain sufficient nutrients through oral or enteral methods, parenteral nutrition is used to prevent malnutrition. Waiting until the seventh day of hospital care is suggested by the American Society for Parenteral and Enteral Nutrition and the Society of Critical Care Medicine (SCCM).

Patients with disorders requiring complete bowel rest, such as bowel obstruction, short bowel syndrome, gastroschisis, prolonged diarrhea regardless of its cause, very severe Crohn's disease or ulcerative colitis and certain pediatric GI disorders, such as congenital GI anomalies and necrotizing enterocolitis, may only be able to receive nutrition through transcutaneous nutrition. The geriatric population has physical, physiological, or mental differences that could cause them to consume fewer nutrients and necessitate nutrition therapy. Compared to younger patients, geriatric patients are more likely to experience delayed muscle restoration. Additionally, insulin resistance, vitamin and mineral deficiencies, and cardiac and renal impairment are seen to be more prevalent in older patients. Parenteral nutrition is a good option for people who need nutrition therapy but are allergic to or unable to eat through an enteral tube. When oral or enteral nutrition is likely insufficient for more than seven to ten days, it is indicated in the elderly population if oral or enteral nutrition is impossible for three days or more. Although there are no geriatric-specific complications of parenteral nutrition, increased comorbidities make complications more common in this population. Malnutrition and cachexia are more common in cancer patients, whether they are outpatients undergoing treatment or in the hospital. The altered metabolism, the increased need for energy, and the reduction in food intake are all factors that contribute to malnutrition in cancer patients. Any nutritional risk should be assessed early on by taking routine weight and BMI measurements on cancer patients. When the digestive tract cannot be reached or is ineffective, parenteral nutrition is recommended for cancer patients. If the approximate survival rate is greater than three months and PN is anticipated to significantly improve the patients' quality of life, the use of PN in advanced cancer patients should be discussed in terms of the risks and benefits. In patients with malignant bowel obstruction, it is unknown whether home parenteral nutrition improves survival or quality of life.

With Regards,
Joseph Kent
Journal Manager
Journal of Clinical Nutrition & Dietetics