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TPN

Alternative Names 
total parental nutrition, TPN, hyperalimentation, central hyperalimentation, parental hyperalimentation

Definition
Hyperalimentation is a procedure in which nutrients and vitamins are given to a person in liquid form through a vein. It is only given to someone who cannot get nutrients from food.

Who is a candidate for the procedure? 
Hyperalimentation is used for people with health problems that prevent them from absorbing enough nutrients through their stomachs. It is also used when a person is severely malnourished and cannot take in food by mouth.

Hyperalimentation might be used: How is the procedure performed? 
A central line is a special intravenous or IV line that is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line, rather than an IV line in an arm, must be used for this procedure because the solution is highly concentrated.

The hyperalimentation solution is tailored to the needs of the person, and contains:
  • glucose, or sugar
  • amino acids
  • electrolytes, such as potassium and sodium
  • vitamins
  • fat emulsion
What happens right after the procedure? 
Hyperalimentation uses a pump to closely regulate the amount of solution given. The person may receive it at a constant rate, or only for several hours at night. Close monitoring is needed. The doctor must check the person's weight, blood sugars, and electrolytes levels in the blood. The doctor must check the site of the central line often for signs of infection.

What happens later at home? 
A nutritional support team will be involved with the use of hyperalimentation. The person's nutritional status is studied and his or her nutritional needs calculated. The solution is changed when the persons needs change. For instance, if a person is taking in food or fluids by mouth, he or she will need fewer kilojoules from the solution. The family will be taught how to administer the hyperalimentation and care for the person if he or she is to receive care at home.

What are the potential complications after the procedure? 
Complications of hyperalimentation may include:
  • too much glucose in the blood
  • too little glucose in the blood
  • infection
  • nausea and headache
  • catheter dislodgement
Author: Gail Hendrickson, RN, BS
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 7/02/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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