Follow the following points for total parenteral nutrition (TPN) or TPN feeding for a patient with weight of 35-40 kilograms:
- Pass CVP line (Use it only for parenteral feeding; don’t infuse other medicines through this line)
- Injection 10% Dextrose Water (D/W) 1000ml + 2KCL + 1Multibionta (Round the clock = @ 11 drops/minute). Note: Monitor random blood sugar level thrice a day; if high- Add 10-12 units insulin R in 10% D/W; if low- Add 25% D/W ampoules in 10% D/W accordingly. Recommended dose of 10% D/W is 30-40ml/kg/day.
- Injection B. Braun Aminoplasmal 10% (Round the clock = @ 6 drops/minute. Recommended dose is 10-20ml/kg/day.
- Injection Lipofundin MCT/LCT 10% + 5000 units of Heparin (Round the clock = @ 6 drops/minute). Recommended dose is 10-20ml/kg/day.
- Control complications! Catheter-related sepsis occurs in ≥ 50% of the patients while glucose abnormalities and liver dysfunction occur in > 90% of the patients.
- Monitoring: RBS thrice a day, Serum electrolytes daily, LFTs daily, Urea/Creatinine daily, Record input/output daily (monitor fluid overload or dehydration).
Keywords: Parenteral nutrition, Parenetral feeding, Central line, TPN feeding, CVP line, Dextrose water, Lipofundin, Aminoplasmal, Complications, Monitoring