Total Parenteral Nutrition
Essential for nurturing severely ill
Total Parenteral Nutrition (TPN) is an alternate form of providing a complete form of nutrition, containing protein, sugar, fat and added vitamins and minerals to those patients who are unable to get full nutrition through mouth. It is crucial for severely ill patients as it keeps people alive where they can not eat to sustain themselves. This method bypasses the digestive tract completely and places nutrients directly into the bloodstream. TPN is required during critical situation, for example, during/after massive bleeding in conditions like bleeding from intestinal tract, paralytic ileus (paralysis of the intestinal muscle), severe and prolonged diarrhoea not responding to any oral or intravenous therapy, intractable vomiting for a continued period, patients with disorders requiring complete bowel rest, critically ill patients on mechanical ventilator for a longer period, severely undernourished patients, patients of severe burns or head trauma and for those who are being prepared for any surgical cause, patients in radio therapy or chemotherapy. TPN is also suggested for sick or premature newborns before starting other feedings or when they can not absorb nutrients through the gastrointestinal tract for a long time. At the time of monitoring, advice of TPN should be sought from the nutrition team and dietitian. TPN is approximately four times the cost of oral feeding. Evaluation of total cost of this procedure is important for scaling up of the system in different hospitals in Bangladesh and it demands critical examination. It is also imperative to examine the potential for transition to oral feedings in individual cases for reducing the hospital cost of the patients. In present situation, we need more randomised controlled trials concerning efficacy of TPN and its cost analyses for betterment of the patients.
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