TPN is used when all or part of a person's digestive system does not work. A person may need TPN because of a gastrointestinal (GI) disorder that severely limits the ability of their digestive tract. A person may not be able to swallow food, move the food through the digestive system, or absorb nutrients from the food.
With TPN, a special intravenous (IV) line is inserted into a vein and nutrients are delivered directly into the bloodstream. The catheter is typically placed in a large vein in the chest and can stay in place for a long period of time, if needed. There are many different kinds of catheters that can be placed based on doctor/hospital preference and the needs of the patient.
Type of Catheters
There are numerous types of catheters available with single or multiple lumens (ports) to allow for simultaneous infusion of multiple fluids and/or medications.
A tunneled catheter (ex. Hickman, Broviac, Leonard) is a type of catheter that is tunneled under the skin and put in place either in a radiology Department or in an operating room. A tunneled catheter can be left in placed for as long as needed.
A Peripherally-Inserted Central Catheter (PICC) is commonly used in patients who require therapy for a short duration, usually for several weeks to a few months. A PICC may be placed at the patient's bedside while in the hospital or by the radiology department.
Ports are often used for patients requiring months to years of therapy and are commonly used where intermittent infusion therapy is needed. A port usually only needs care when it is accessed. A port is accessed by using a special needle inserted through the skin and into the port hub. Ports are well liked because they are fairly inconspicuous when not accessed. Placement of a port usually occurs in an operating room or by a Radiologist with X-ray guidance.
In some cases, IV nutrition is used temporarily until a person is able to tube feed again. In other cases, TPN becomes the main and/or only form of nutrition. The amount of time a person requires TPN varies. TPN can be given for as long as is needed and it can be given to all ages, including infants and children as well as adults. There are many people who live very well on TPN for many, many years.
The length of time that TPN is infused depends on each individual’s needs and is determined by your team of doctors. It can run anywhere from 10-24/hrs. per day, most individuals run their TPN at night to allow freedom during the daytime.
TPN is more costly and dangerous than enteral feeding and every attempt should be made when possible to use the enteral path first.