Introduction – What is parenteral nutrition?
Parenteral nutrition is the administration of a nutritional solution by infusion. All the necessary nutrients are fed directly into the vein. This bypasses the digestive tract, i.e. the stomach and intestines. A further distinction is made between total parenteral nutrition (TPE), in which all nutrition is administered intravenously, and supplemental parenteral nutrition (SPE), in which additional oral (normally via the mouth) or enteral nutrition (e.g. via a stomach tube) is administered. Parenteral nutrition is always necessary if the patient is not able to take in nutrients in the normal way or not sufficiently.
How does parenteral nutrition work?
With parenteral nutrition, an infusion solution is administered which contains all the necessary nutrients and thus provides the patient with as many calories as he or she needs. The access route for parenteral nutrition is usually a central venous catheter (CVC), which lies in a large vein such as the subclavian vein and is advanced into the superior vena cava. If it is foreseeable that parenteral nutrition is to be administered over a longer period of time, a port system can be used as an alternative.
Here, too, a large vein is punctured and a chamber is placed under the skin, which can then be punctured from the outside. A port is inserted under general anesthesia. As a short-term solution, a low caloric solution can also be administered through a normal peripheral venous catheter. High-caloric nutritional solutions or the administration of nutritional solutions over a longer period of time lead to venous irritation and are therefore not performed.
When is parenteral nutrition used?
Parenteral nutrition is used whenever it is not possible for the patient to meet his or her nutritional requirements by oral (via the mouth) or enteral nutrition (via a stomach tube). Reasons for parenteral nutrition can be Bleeding in the gastrointestinal tract Absorption disorders in the gastrointestinal tract Transport disorders: intestinal obstruction or tumors of severe progression of chronic inflammatory bowel diseases severe burns or trauma cancer chemo- or radiotherapy
- Bleeding in the gastrointestinal tract
- Uptake disorders in the gastrointestinal tract
- Transport problems: Intestinal obstruction or tumors
- Severe courses of chronic inflammatory bowel diseases
- Severe burns or trauma
- Cancer diseases
- Chemo- or radiotherapy
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