Metabolic Complications Associated With Total Parenteral Nutrition
DOI:
https://doi.org/10.22270/ajprd.v11i2.1237Keywords:
Total parenteral nutrition (TPN), metabolic complications, electrolyte abnormalities, refeeding syndrome (RFS), hyperglycemia, hypertriglyceridemia, hepatobiliary dysfunction.Abstract
Total parenteral nutrition (TPN) is a very important means of providing nutrients to patients who have no access to receiving nutrients by enteral route. It consists of all the essential components like lipids, protein, dextrose, electrolytes, vitamins, minerals and trace elements. The concentration of all these components can be adjusted according to the requirement of the patients. They are also available as fixed solutions. Administration of TPN requires careful monitoring as small change in concentration of nutrients in the solution may cause serious, life-threatening complications. Metabolic complications like electrolyte abnormalities, refeeding syndrome, hyperglycemia, hypertriglyceridemia and many hepatobiliary dysfunctions like steatosis, cholestasis, hepatic dysfunction and gallbladder dysfunction are all associated with the use of total parenteral nutrition.
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2. Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Long-term total parenteral nutrition with growth, development and positive nitrogen balance. Surgery 1968. 64: 134-142. Nutr. Hosp. 2001;16(6):286-92.
3. Chowdary KV, Reddy PN. Parenteral nutrition: revisited. Indian journal of anaesthesia. 2010 Mar;54(2):95.
4. Ziegler TR. Parenteral nutrition in the critically ill patient. New England Journal of Medicine. 2009 Sep 10;361(11):1088-97.
5. Heyland DK, MacDonald S, Keefe L, Drover JW. Total parenteral nutrition in the critically ill patient: a meta-analysis. Jama. 1998 Dec 16;280(23):2013-9.
6. Gosmanov AR, Umpierrez GE. Management of hyperglycemia during enteral and parenteral nutrition therapy. Current diabetes reports. 2013 Feb;13:155-62.
7. Jauch KW, Schregel W, Stanga Z, Bischoff SC, Brass P, Hartl W, Muehlebach S, Pscheidl E, Thul P, Volk O, Working group for developing the guidelines for parenteral nutrition of The German Association for Nutritional Medicine. Access technique and its problems in parenteral nutrition–guidelines on parenteral nutrition, chapter 9. GMS German Medical Science. 2009;7.
8. Ghosh D, Neild P. Parenteral nutrition. Clinical medicine. 2010 Dec;10(6):620.
9. Kushner RF. Total parenteral nutrition‐associated metabolic acidosis. Journal of Parenteral and Enteral Nutrition. 1986 May;10(3):306-10.
10. Marinella MA. The refeeding syndrome and hypophosphatemia. Nutrition reviews. 2003 Sep 1;61(9):320-3.
11. Pantoja F, Fragkos KC, Patel PS, Keane N, Samaan MA, Barnova I, Di Caro S, Mehta SJ, Rahman F. Refeeding syndrome in adults receiving total parenteral nutrition: an audit of practice at a tertiary UK centre. Clinical Nutrition. 2019 Jun 1;38(3):1457-63.
12. Dacey MJ. Hypomagnesemic disorders. Critical care clinics. 2001 Jan 1;17(1):155-73.
13. Chrisanderson D, Heimburger DC, Morgan SL, Geels WJ, Henry KL, Conner W, Hensrud DD, Thompson G, Weinsier RL. Metabolic complications of total parenteral nutrition: effects of a nutrition support service. Journal of Parenteral and Enteral Nutrition. 1996 May;20(3):206-10.
14. Klein GL. Metabolic bone disease of total parenteral nutrition. Nutrition. 1998 Jan 1;14(1):149-52.
15. Solomon SM, Kirby DF. The refeeding syndrome: a review. Journal of Parenteral and Enteral Nutrition. 1990 Jan;14(1):90-7.
16. Thompson JS, Hodges RE. Preventing hypophosphatemia during total parenteral nutrition. Journal of Parenteral and Enteral Nutrition. 1984 Mar;8(2):137-9.
17. Pasquel, F. J., Spiegelman, R., McCauley, M., Smiley, D., Umpierrez, D., Johnson, R., Rhee, M., Gatcliffe, C., Lin, E., Umpierrez, E., Peng, L., &Umpierrez, G. E. (2010). Hyperglycemia during total parenteral nutrition: an important marker of poor outcome and mortality in hospitalized patients. Diabetes care, 33(4), 739–741. https://doi.org/10.2337/dc09-1748
18. Chait A, Subramanian S. Hypertriglyceridemia: pathophysiology, role of genetics, consequences, and treatment. Endotext [Internet]. 2019 Apr 23.
19. Raman M, Almutairdi A, Mulesa L, Alberda C, Beattie C, Gramlich L. Parenteral nutrition and lipids. Nutrients. 2017 Apr 14;9(4):388.
20. Angelico M, Guardia PD. Hepatobiliary complications associated with total parenteral nutrition. Alimentary Pharmacology & Therapeutics. 2000 May;14:54-7.
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