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Total nutrient admixture: a review.

R Brown, R A Quercia, R Sigman

    JPEN. Journal of Parenteral and Enteral Nutrition
    |November 1, 1986
    PubMed
    Summary
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    The Total Nutrient Admixture (TNA) system offers advantages for nutritional support but requires careful consideration of potential disadvantages. Further research is needed to establish TNA stability and understand the long-term effects of larger lipid droplet sizes.

    Area of Science:

    • Nutritional Support
    • Biochemistry
    • Clinical Nutrition

    Background:

    • Total Nutrient Admixture (TNA) systems are increasingly popular for nutritional support in hospitalized and home patients.
    • TNA offers unique advantages over traditional Total Parenteral Nutrition (TPN) methods.
    • However, potential disadvantages and uncertainties require careful evaluation.

    Purpose of the Study:

    • To review the advantages and disadvantages of the TNA system for nutritional support.
    • To highlight the need for further research into TNA stability and long-term effects.
    • To discuss the biological implications of TNA lipid emulsion properties.

    Main Methods:

    • Review of existing literature on TNA systems.
    • Analysis of stability studies and particle size distribution data.

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  • Comparison of TNA lipid droplet characteristics with standard lipid emulsions and chylomicrons.

    • Main Results:

    • TNA systems have larger lipid droplet sizes (several times greater than 0.2-0.4 microns).
    • The long-term consequences of infusing these larger droplets are not fully known.
    • Subtle differences in lipid emulsion properties, such as the phospholipid layer, may affect metabolism.
    • Concerns exist regarding enhanced microorganism growth in TNA systems.

    Conclusions:

    • The advantages of TNA must be weighed against potential risks and uncertainties.
    • Further investigation into TNA stability, droplet characteristics, and biological implications is crucial.
    • The long-term safety and efficacy of TNA require more established evidence.