When a person's digestive system has shut down (such as from peritonitis) and their weight is low enough to raise concerns about nutrition during an extended hospital stay, short-term PN may be used. Patients who are dealing with the long-term effects of an accident, surgery, or digestive disorder may occasionally be treated with long-term PN. Children who were born with severely malformed or absent organs have lived longer thanks to PN. In the United States, approximately 40,000 individuals use TPN at home. Because TPN must be administered for 10-16 hours, daily life may be affected. The majority of patients agree that modifying one's daily routine is preferable to hospitalization. To shorten the amount of time a patient spends hooked up, there are many different kinds of pumps. For mobility, a backpack pump is typically used. Each patient's situation determines how long it takes to connect to the IV; some require five days a week or once daily.

Patients must avoid as much lifestyle modification as possible related to TPN. This makes it possible to have the best mental health possible; resentment and depression can result from being held back constantly. Patients must refrain from swimming (infection) and contact sports (damage to equipment), both of which are highly encouraged forms of physical activity. Due to issues with body image and being unable to participate in activities and events, many teens find living with TPN difficult. The GI tract and conventional methods of nutrient absorption are completely bypassed by TPN. The following is a list of possible complications that could be significant. Hypophosphatemia, hypokalemia, hyperglycemia, hypercapnia, decreased copper and zinc levels, elevated prothrombin time (if associated with liver injury), hyperchloremic metabolic acidosis, and decreased gastrointestinal motility are other common complications of TPN. The most common problem with TPN is an infection of the catheter, which is required for the solution to pass through. These patients frequently succumb to septic shock after an infection, which has a mortality rate of approximately 15% per infection.

Compared to jugular and femoral vein insertions, the subclavian (or axillary) vein is preferred for central venous access due to its ease of access and lower infectious complications. Pneumothorax, accidental arterial puncture, and catheter-related sepsis are all complications of the procedure. At the time of insertion, the complication rate should be less than 5%. By choosing the right catheter and using the right method to insert it, infections caused by catheters can be reduced. Blood clots frequently form on this IV line due to chronic IV access, which introduces a foreign object into the vascular system. Pulmonary embolism, in which a clot that begins on the IV line ruptures and travels to the lungs, preventing blood flow can cause death.

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