Parenteral nutrition

During the more than 25 years since total parenteral nutrition (TPN) was successfully used in animals, there have been multiple studies examining the indications, techniques, and improvements associated with TPN. This review focuses only on those articles identified using a MEDLINE search that appeared over the previous 12 months. Articles were selected that examined the indications, composition, techniques, and complications of TPN. These articles demonstrate that TPN is a maturing nutrition support regimen, Many of the initial optimistic predictions made for TPN have not come true. Furthermore, TPN is associated with a relatively high incidence of complications related to the use of central venous catheters. The requirement that all nutrients be supplied intravenously, bypassing the gastrointestinal tract, also has created problems. As technology matured, along with the recognition that there are some patients who cannot be alimented any other way, we have gained insight into who should receive TPN; the amount of fat, carbohydrate, and protein that should be administered; and how complications associated with TPN should be managed.