Nutrition via the Veins
The science and art of feeding patients through their blood vessels has become a life saving part of critical care medicine. Many patients cannot eat but must be fed to get better, so total parenteral nutrition (TPN) emerged to meet that need and continues to be a refined science of feeding those who cannot use their alimentary tract.
Besides providing the calories they need, special nutrients can also be delivered to aide in the recovery process. A high protein intake, for example, has been associated with increased survival in burn patients. Glutamine is essential for those with compromised immune systems and aides in conquering infections.
According to Dr. Jeejeeboy, “the bottom line is that you want to feed the patient and make sure that they don’t starve and at the same time you don’t want to make them sick by over-feeding them”. With TPN, a central catheter is inserted and nutrients are infused into the Subclavian or jugular vein bypassing the gastrointestinal tract.
Studies have shown that TPN – if used correctly- can reduce mortality. Today, TPN is used to help people with cancer, bowel disease, cystic fibrosis, AIDS, and others at risk for malnutrition and its complications.
While many people recover and can be weaned off TPN and put on regular food or tube feeding, many others do not recover and depend on home parenteral nutrition or HPN. Despite the fact that HPN can be life-saving for people who have lost their gut function, there are psychological and technological burdens for patients on HPN.
A study done in Denmark on HPN patients showed reduced strength for physical activity , feelings of depression and anger, loss of independence and reduced social interaction.
Groups like the Oley Foundation are available in the US to support HPN patients, offering them information, education and support meetings.
For more information on TPN, contact the American Society of Parenteral and Enteral Nutrition. For more information on the Oley Foundation, contact Oley’s website.
About the author
Kathy Shattler received her Master of Science degree from Michigan State University in E. Lansing Michigan in Human Nutrition. Her twenty-two years of practice includes holding positions as a Lecturer, Chief Clinical Dietitian and Program Manager. Kathy is the Founder of Nutri-Care Consulting and is currently the Nutrition Director of www.CEU4U.COM, an online continuing education management company for Registered Dietitians and Dietetic Technicians.
