What Is Total Parenteral Nutrition? Everything to Know

Medically Reviewed By Jared Meacham, Ph.D., RD, PMP, CSCS

Total parenteral nutrition (TPN) involves administering nutrition intravenously. You may need TPN if there are problems with your gastrointestinal tract. Unlike partial parenteral nutrition, which supplements oral food intake, TPN provides all your daily nutritional requirements. It is possible to receive TPN at the hospital or at home.

Read on to learn more about TPN’s purpose and how it works. This guide also looks at administering TPN at home, the risks of TPN, when to see a doctor, and more.

What is the purpose of total parenteral nutrition?

A doctor is holding a feeding bag.
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Total parenteral nutrition (TPN) provides you with all your nutritional needs intravenously.

Doctors recommend IV nutrition Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source if you cannot take food and drink orally and if tube feeding, also known as enteral nutrition, is not an option.

According to Merck Manual, conditions that may require TPN include:

Learn more about gastrointestinal problems.

How does total parenteral nutrition work?

Total parenteral nutrition (TPN) includes all the nutrition you need. This includes Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

  • amino acids
  • dextrose
  • electrolytes
  • lipid emulsions
  • minerals
  • proteins
  • trace elements
  • vitamins

Ordinarily, your food and drink travel through the digestive system. Your body then absorbs it into your blood.

If food cannot travel through your digestive tract, or if you require complete bowel rest, TPN allows your bloodstream to absorb all of the nutrients directly, bypassing the digestive system.

Learn about macronutrients.

What is the total parenteral nutrition procedure like?

Total parenteral nutrition (TPN) uses a solution that mixes all the nutrients you require in one bag. You will receive this solution intravenously.

You will typically receive TPN through a central venous catheter Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source . This is a catheter doctors insert into a vein in the neck or thigh or just under your collarbone. You will typically receive an anesthetic before receiving the catheter in theater or the X-ray department.

Once you receive TPN, your care team will regularly monitor you. This includes conducting a full nutritional assessment every 2 weeks to monitor your body mass index and body measurements.

How do I administer total parenteral nutrition at home?

According to the UPMC Children’s Hospital of Pittsburgh, around 40,000 people in the United States receive total parenteral nutrition (TPN) at home.

Before you leave the hospital, your medical team will provide detailed instructions on administering TPN at home.

You will need to clamp the feeding bag onto the catheter each day. The UPMC Children’s Hospital of Pittsburgh recommends doing this at night, particularly for children receiving TPN, to avoid the complication of moving about with tubes during the day.

What are the risks of total parenteral nutrition?

Around 5–10% of people receiving total parenteral nutrition (TPN) experience central venous access complications, according to the Merck Manual. This can include Trusted Source PubMed Central Highly respected database from the National Institutes of Health Go to source :

However, increased training and guidelines on sterile techniques have decreased complications such as catheter-related sepsis.

Other possible complications of TPN include:

  • glucose abnormalities, which affect more than 90% of people receiving TPN
  • liver dysfunction, particularly in infants receiving TPN
  • hepatomegaly, which is an enlarged liver
  • hyperammonemia, a metabolic condition that can affect infants
  • serum electrolytes or minerals abnormalities
  • metabolic bone disease
  • problems with your gallbladder
  • reaction to lipid emulsions

Contact your doctor if you have concerns about TPN’s possible risks or complications. They can provide you with more information and answer any questions.

When do doctors not recommend total parenteral nutrition?

While doctors recommend total parenteral nutrition (TPN) when you may not be able to take food orally, there are other situations where TPN may not be suitable.

Generally, your doctor will not recommend TPN if tube feeding is an option. According to a 2020 article Trusted Source Wiley Peer reviewed journal Go to source , TPN may not be advisable if you can meet your nutritional needs within 5–7 days either orally or via tube feeding.

The same article states doctors should recommend parenteral nutrition cautiously in the following situations:

When should I see a doctor?

Contact a doctor if you or a child receive total parenteral nutrition (TPN) and have questions. They can provide information about your needs.

If you are booked to receive a catheter for TPN, you may want to talk with your doctor or surgeon beforehand. They can tell you what to expect during and after the procedure, helping to provide peace of mind.

Summary

Total parenteral nutrition (TPN) provides nutrition intravenously. Doctors recommend TPN if there are problems with your digestive system and you cannot receive nutrition via tube feeding.

After your doctor inserts the catheter at the hospital, you will receive information on how to administer TPN at home. This includes attaching a bag containing a solution to the catheter daily.

Contact your doctor if you have questions about TPN or the initial procedure. They can answer any questions, so you feel fully informed about what to expect. You will also have a care team monitoring you on an ongoing basis once you receive TPN.

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  1. Fetterplace, K., et al. (2020). Parenteral nutrition in adults during acute illness: A clinical perspective for clinicians. https://onlinelibrary.wiley.com/doi/full/10.1111/imj.14786
  2. Hamdan, M., et al. (2022). Total parenteral nutrition. https://www.ncbi.nlm.nih.gov/books/NBK559036/
  3. Home parenteral nutrition (HPN) – information for patients. (2019). https://www.hey.nhs.uk/patient-leaflet/home-parenteral-nutrition-hpn-information-patients/
  4. Thomas, D. R. (2022). Total parenteral nutrition (TPN). https://www.merckmanuals.com/professional/nutritional-disorders/nutritional-support/total-parenteral-nutrition-tpn
  5. Total parenteral nutrition (TPN) frequently asked questions. (n.d.). https://www.chp.edu/our-services/transplant/intestine/recovery/life-after/total-parenteral-nutrition/frequently-asked-questions

Medical Reviewer: Jared Meacham, Ph.D., RD, PMP, CSCS
Last Review Date: 2022 Sep 26
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