What Does TPN/HPN Look Like?
This is a Bag of Home Parenteral Nutrition (HPN)
The contents of the Parenteral Nutrition (PN) solution are determined based on the age, weight, height, and the medical condition of the individual. All solutions contain sugar (dextrose) for energy and protein (amino acids). Fats (lipids) may also be added to the solution. Electrolytes such as potassium, sodium, calcium, magnesium, chloride, and phosphate are also included, as these are essential to the normal functioning of the body. Trace elements such as zinc, copper, manganese and chromium are also needed. Vitamins can be included in the PN solution, and insulin, a hormone that helps the body use sugar, may need to be added. The PN Central Line is used only for nutrients; medications are not added to the solution.
The PN solution is infused slowly at first to prevent fluid imbalances, then the rate is gradually increased. The infusion time varies between 12-24hrs. Some individuals may have their PN infused gradually or ramp down towards the end to prevent blood sugars from plummeting.
On a regular basis bloods are taken to monitor an individual's hydration status, renal function, risk of re-feeding syndrome, and both electrolyte deficiencies and excesses. Responding appropriately to this, in turn, will help to minimise the risk of complications. Electrolytes (Sodium, Potassium & Magnesium), bone profile (Calcium & Phosphate), infection markers (such as C Reactive Protein and white blood cells) and liver function tests are also taken.
For patients on HPN they will be required to attend regular clinic reviews and may need to take in stool and urine samples to check their urinary electrolytes (sodium and potassium levels).