Total parenteral nutrition (TPN)

When your digestive system can’t handle food for some reason, your doctor may recommend total parenteral nutrition (TPN) so you can continue to get nutrition and fluids. TPN bypasses the digestive system and can be helpful for certain bowel conditions or when you’re receiving chemotherapy.

What is TPN?

TPN provides a liquid mixture of carbohydrates, amino acids (protein), fats and other nutrients and is infused through an IV into your bloodstream.

IVs for total parenteral nutrition are often inserted through a central line that is placed on your chest. A port will be placed just under your skin during a simple surgery. Placing the port near your heart makes it easier to insert a catheter to deliver TPN nutrition to the large blood vessels of the heart.

Ports can be used for short-term or long-term care. They make it easier to provide both nutrition and medicine.

TPN nutrition can also be delivered through an IV in your arm. This kind of port is called a peripherally inserted central catheter (PICC). The catheter is fed gently through veins until it reaches your heart.

Another type of parenteral nutrition is partial parenteral nutrition, meaning you’re able to tolerate some food by mouth. Your health care team will work with you to make sure you’re getting the right balance of nutrients whether you’re getting total parenteral nutrition or partial parenteral nutrition.

Another method of artificial feeding – enteral nutrition – may be used when you can tolerate food in your stomach or intestines. The nutrients are still provided in liquid form, but they are delivered through a catheter inserted into your stomach or small intestine.

Side effects of total parenteral nutrition

The main side effects of using TPN nutrition are infections that spread from the catheter and shutdown of the digestive tract. Other possible side effects are:

• Bleeding
• Blood clots where the catheter meets the vein
• Gallbladder or liver damage
• Glucose or other nutrient imbalances

Conditions that may call for total parenteral nutrition

TPN is used to provide nutrition and fluids to people who can’t swallow or digest food for reasons such as:

• Abdominal trauma
• Dysphagia (inability to swallow following stroke)
• Gastrointestinal disorders
• Inflammation of the intestines due to radiation treatment
• Premature birth
• Resting the digestive system after surgery
• Severe vomiting or diarrhea
• Side effects of chemotherapy
• Some cancers of the digestive tract

Short bowel syndrome

Another condition that may require total parenteral nutrition to be used is short bowel syndrome. Short bowel syndrome is a rare condition that may happen because a person has:

• Had all or part of their large intestine removed
• Had at least half of their small intestine removed
• Poor movement of food through the intestines
• Significant damage to the small intestine