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First choice for total parenteral nutrition: the peripheral route
1Department of Gastroenterology and Nutrition, Central Middlesex Hospital, London, United Kingdom.
JPEN. Journal of Parenteral and Enteral Nutrition
|September 1, 1993
Summary
Peripheral parenteral nutrition (PPN) offers a safer alternative to central venous TPN, reducing risks associated with catheterization. Advances in understanding and techniques now make PPN feasible for many hospitalized patients needing short-term intravenous feeding.
Area of Science:
- Clinical Nutrition
- Vascular Access
- Parenteral Therapy
Background:
- Total parenteral nutrition (TPN) traditionally requires central venous access due to thrombophlebitis risk in peripheral veins.
- Central venous catheterization for TPN is linked to significant morbidity and mortality.
- Safer TPN administration necessitates avoiding central venous catheters.
Purpose of the Study:
- To evaluate the feasibility and safety of administering TPN via the peripheral route.
- To highlight advancements enabling peripheral parenteral nutrition (PPN).
- To identify patient populations suitable for PPN.
Main Methods:
- Review of pathophysiology of peripheral vein thrombophlebitis.
- Application of techniques to prevent or delay peripheral vein thrombophlebitis.
- Incorporation of recent TPN practice changes, including reduced caloric loads and lipid emulsions.
Main Results:
- Peripheral parenteral nutrition is now a viable option for TPN delivery.
- Understanding thrombophlebitis allows for safer peripheral venous access.
- Modified TPN practices enhance the applicability of PPN.
Conclusions:
- Peripheral parenteral nutrition can be safely administered, avoiding central venous catheter complications.
- PPN is applicable to most hospitalized patients requiring intravenous feeding for 10-14 days.
- Advancements in TPN management make peripheral administration a practical alternative.