Parenteral nutrition (Greek para: besides; enteron: intestine; “bypassing the digestive tract“) is a medical treatment and refers to a form of artificial nutrition for patients whose oral (intake of food by mouth) or enteral (intake of food via the digestive tract) intake of macro- and micronutrients (nutrients, vital substances) is disturbed to the extent that it no longer meets their needs. These patients rely on intravenous administration of nutrients, vital substances, fluids, and electrolytes to maintain their nutritional status or quality of life.
Indications (areas of application)
- The digestive tract is not able to absorb macro- and micronutrients (nutrients, vital substances).
- Enteral nutrition (absorption of food through the digestive tract) worsens the disease, for example, in acute pancreatitis (inflammation of the pancreas).
- Speak against enteral nutrition an ileus (intestinal obstruction) or severe diarrhea (diarrhea).
- Unstoppable vomiting impedes enteral nutrition, for example, in the context of chemotherapy for tumor diseases.
- There is cachexia (emaciation of the organismuś; catabolic metabolic situation) due to cancer.Attention!In the case of cachexia, early nutritional therapy should begin, especially to promote the treatment of the disease, since a good nutritional status can improve the effects of therapy (eg, chemotherapy or radiotherapy).
- Enteral nutrition does not cover the macro- and micronutrient needs (nutrients, vital substances), for example, in short bowel syndrome (clinical picture resulting from the surgical removal of parts of the small intestine) or hypermetabolic metabolism (increased metabolism, for example, in severe burns or cystic fibrosis (cystic fibrosis); metabolic disease in which the body’s own glands produce a viscous secretion that impairs numerous bodily functions).
- Parenteral nutrition has a therapeutic effect, for example, in chronic inflammatory diseases of the digestive tract (Crohn’s disease, ulcerative colitis).
- An exact dosage of the nutrient administration is necessary, for example, in coma hepaticum (liver decay coma).
The procedure
The aim of parenteral nutrition is to maintain, restore and stabilize the vital functions of the organismuś and thus improve the quality of life. It also focuses on the prevention and treatment of malnutrition (malnutrition). Parenteral nutrition can be used both as an inpatient and in the home.The special infusion solutions of parenteral nutrition are mixtures of water, electrolytes, carbohydrates (mostly glucose), amino acids, fats, vitamins, minerals and trace elements. The ratio of ingredients must be adjusted to individual needs (nutritional status, disease state, consumption of nutrients/vital substances). In addition, the patient’s consent is necessary, since it is an artificial nutrition.The following infusion solutions are suitable for parenteral nutrition and can be administered in combination or separately:
- Amino acid standard solutionThese solutions contain essential (the body cannot produce these amino acids itself) and nonessential amino acids. They are useful in normal or in post-traumatic metabolic state (eg, after an accident).
- Amino acid special solutionsThis is a mixture for patients with pathophysiologically (disease-related) altered amino acid metabolism, such as liver or kidney insufficiency (liver or kidney weakness).
- Carbohydrate solutionsThey usually contain glucose or are composed of different carbohydrates (sugars). These infusion solutions are partly also available in combination with electrolytes.
- Fat emulsionsThese infusion solutions are energy sources with very high energy density. Fat emulsions can be added amino acid or carbohydrate solutions.
- Vitamin and trace element preparationsVitamins and trace elements are essential dietary components (vital substances) and can be administered via various preparations in different concentrations.
Your benefit
Parenteral nutrition enables you to provide adequate nutrition not only as an inpatient, but also in the home setting when necessary.For the patient, this means above all an increase in quality of life, as he or she can continue to maintain social contacts well.
