Tips On How To Review For ISPN Examinations
08
Parenteral Nutrition
胃肠外营养
Parenteral nutrition (PN,胃肠外营养) is the administration of nutritional support via the intravenous route, either central (CPN) or peripheral (PPN), when patients fail to meet their nutritional needs by the oral or enteral routes due to certain conditions or procedures, such as comatose, undergoing aggressive cancer therapy. The basic difference between central and peripheral accesses is the concentration of the solutions infused. Hyperalimentation is another term sometimes used synonymously with parenteral nutrition.
Total parenteral nutrition (TPN,胃肠外全面营养) is a highly concentrated, hypertonic nutrient solution. It provides calories, restores nitrogen balance, and replaces essential fluids, vitamins, electrolytes, minerals, and trace elements. It meets the patient’s nutritional needs by way of nutrient-filled solutions administered intravenously through a central venous access device.
Peripheral parenteral nutrition (PPN,周围静脉营养) is a less concentrated nutrient solution sometimes prescribed for patients who have a malfunctioning gastrointestinal tract and need short-term nutrition lasting less than 2 weeks. It is isotonic and administered through a peripheral vein. Peripheral veins cannot tolerate highly concentrated solutions, so the solution is not as nutrient dense as TPN.
Physical incompatibility (物理学配伍禁忌) between the intravenous nutrition formula and other intravenous solutions, especially medications, is a potential problem and must be addressed. Avoiding use of the lumen or administration set for parenteral nutrition for another purpose, when a multilumen catheter is in place, helps prevent incompatibility problems and reduce the risk for infection.
Reviewing of parenteral nutrition will be focused on the clinical indications for parenteral nutrition, types of intravenous access required to administer parenteral nutrition, risks and potential complications of parenteral nutrition, and monitoring and management of these complications. They will be discussed in three parts as well.
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