Intravenous Nutrition Therapy – What It Is?

1. Intravenous nutrition therapy goes by other names, such as Total Parenteral Nutrition (TPN) or parenteral nutrition.
2. This treatment delivers essential nutrients straight into their blood through a vein.
3. Intravenous nutrition therapy can provide a solution that contains carbohydrates, proteins, fats, vitamins, minerals, and electrolytes directly into the bloodstream.
4. These solutions can be adapted to meet individual nutritional requirements.
5. In cases where critically ill patients cannot cope with enteral nutrition or feeding by mouth because of hemodynamic instability, mechanical ventilation, or gastrointestinal dysfunction, intravenous nutrition support may be invaluable.
6. Some individuals put on weight when having intravenous nutrition – especially if they are given too many calories or their metabolic rate falls.

Introduction

If you or someone in your family are undergoing IV nutrition therapy (IVNT) as part of your care routine, you might want to know more about this treatment. This article looks at the advantages of IVNT, potential side effects, and ways to prevent them from occurring.

What is Intravenous Nutrition therapy?

Intravenous nutrition therapy (IVNT) is called Total Parenteral Nutrition (TPN) or parenteral nutrition. It is a method used in healthcare to provide vital nutrients straight into the blood through a vein. Clinicians turn to this technique when someone can’t get all the necessary nourishment through eating or tubes (enteral routes). This can happen because of gastrointestinal disorders, bowel blockages, serious malabsorption syndromes, or other medical problems that interfere with normal digestion and nutrient absorption.

How does Intravenous Nutrition therapy work?

Intravenous Nutrition Therapy usually requires a unique mixture with just the right balance of fats, proteins, carbohydrates, minerals, vitamins, and electrolytes. This blend is customized based on individual patients’ nutritional requirements – determined by their metabolic rate, medical condition(s), and current nutritional intake.

The solution is administered through a central venous catheter (CVC) or a peripherally inserted central catheter (PICC) placed into a large vein, usually in the chest or arm. This allows for the continuous infusion of nutrients directly into the bloodstream, bypassing the digestive system entirely.

Benefits of IV nutrition therapy

IV nutrition therapy benefits patients who can’t get enough nutrients orally or through feeding tubes. The advantages include:

• Better nutrition: IV therapy provides carbs, proteins, fats, vitamins, minerals, and fluids straight into your veins – essential when you’re too sick to eat. Each patient gets a feed tailor-made for them so no deficiencies develop. It also gives the digestive system a break from food.
• Faster healing: When people are severely unwell, their intestines may not absorb things well. Giving nutrients intravenously bypasses this problem because it goes right into circulation, meaning body cells can use them immediately. There is some evidence this approach has helped individuals recover more quickly from illness injury.
• Muscle mass: Some individuals lose weight, especially muscle bulk (mass) when they become poorly because the body starts breaking down tissue energy. If someone becomes malnourished while ill, their muscles may waste further – this can lead to not being able to breathe without help from the intensive care unit (ICU).
• Fewer infections: A person’s immune system needs nourishment to work properly (including fighting off infections). If somebody does not eat for a prolonged period and becomes weak or ill, their natural defenses will be impaired.
• Helping Out During Serious Sickness: For people in intensive care who can’t eat by mouth or through a feeding tube because they’re hooked up to a machine to help them breathe, their blood pressure is very low and can’t be stabilized, or their intestines aren’t working properly, IV nutrition can be a real lifeline. Getting nutrients straight into a vein when they’re sick helps them get better and lowers their chances of having problems from not eating enough while their body is under so much stress.
• Giving Nutritional Back-Up Long-Term: IV nutrition is also an ongoing support for patients with serious intestinal problems that stop them from absorbing food properly over the long haul — like short bowel syndrome or chronic intestinal failure. People in this situation may be taught how to look after themselves on home-based IV nutrition programs, which enable them to maintain good health and stay out of the hospital for regular treatment sessions aimed solely at keeping their nutrient levels where they should be; this has positive effects on both how well they can carry out daily activities and overall quality-of-life measures.

Risks and side effects of IV nutrition therapy

Although IV nutrition therapy has its advantages, it also poses risks and potential side effects. These include:

• Infection: IV catheters raise the likelihood of infection at the insertion site or along the catheter tract. Such infections can be localized (e.g., cellulitis or abscesses) or systemic (e.g., bloodstream infections/sepsis). Careful catheter maintenance and sterile techniques are crucial to minimize this risk.
• Catheter-related problems: IV catheters may cause mechanical complications like dislodgement, kinking, or occlusion, which can interrupt the flow of IV fluids and nutrients. There is also a possibility of catheter-related thrombosis (blood clots), which can lead to such complications as deep vein thrombosis or pulmonary embolism.
• Metabolic disturbances: IV nutrition therapy can unsettle normal metabolism in various ways, for example, by boosting blood sugar levels (hyperglycemia), raising triglyceride levels (hypertriglyceridemia), or causing electrolyte imbalances (e.g., hyperkalemia, hypokalemia or hypocalcemia). Regular monitoring of blood glucose and electrolyte levels is essential to prevent or correct any such problems.
• Liver problems: Long-term use of IV lipid emulsions in parenteral nutrition can give rise to hepatic steatosis (fatty liver) and liver dysfunction — particularly in patients with impaired lipid metabolism or those getting high doses of lipids. It is advisable to keep tabs on liver function through regular tests because any signs of liver trouble need managing.
• Fluid overload: IV nutrition therapy might result in too much fluid entering the circulation, especially if it is given quickly (at a high infusion rate) or to patients whose cardiac or renal function is compromised. If someone receives an excessive volume of fluid, they may develop edema, congestive heart failure, or pulmonary edema. So, doctors must carefully watch patients’ fluid balance and adjust infusion rates accordingly.
• Refeeding syndrome: Starting IV nutrition in malnourished patients can trigger this response if feeding is increased rapidly; it includes electrolyte imbalances (especially hypophosphatemia), fluid shifts, and metabolic disturbances. To reduce the chance of refeeding syndrome, closely observe and slowly reintroduce nutrition.
• Allergic reactions: People given nutrients via IV might react badly to some of them – like vitamins, lipid emulsions, or trace elements – in the solution. This could cause symptoms such as itching, rash, breathing problems, hives, or anaphylaxis (a serious condition that affects the whole body).
• Problems linked with too much sugar in your blood: If dextrose from an IV drip raises your glucose levels too high, there are risks like infections taking hold (especially if wounds take ages to heal), hyperosmolar hyperglycemic state or diabetic ketoacidosis (sometimes called ‘diabetic coma’) – these conditions can be life-threatening but are quite rare.
• Shortages of essential nutrients: Even when patients are fed intravenously, certain key minerals and vitamins may run low over time if not enough has been given; regular blood tests help doctors spot any deficiencies before they become too serious.
• Psychological effects of going without food orally for long periods: Some individuals find they become worried about needing tube feeding all time, while others feel fed-up because they’ve lost their independence, having been self-reliant on normal eating (taking account personal likes/dislikes) until now; it is also possible both groups may experience decreased quality-of-life issues such as feeling down or finding day-to-day activities difficult to cope with alone anymore — advice from professionals trained specially in dealing these matters could prove helpful here.

Frequently asked questions

How long is IV nutrition therapy usually required?

The duration of IV nutrition therapy can vary depending on a few factors, including the patient’s underlying health condition, current nutritional status, and how well they can manage either eating or having a feeding tube put in. If someone needs help for a short time because they are very sick, that can be arranged – but other individuals might get it non-stop over many years.

IS IV nutrition therapy safe?

It’s important to take certain steps so that this treatment option does not make someone feel even worse or cause other medical problems. These steps include:

1. Be extremely careful when placing a catheter or changing a bandage. (If germs get inside the body through the catheter, this could lead to a serious infection.)
2. Watching closely for any signs of infection or other issues.

Sources

Dayal, Sahil BS; Kolasa, Kathryn M. PhD, RDN, LDN. Consumer Intravenous Vitamin Therapy: Wellness Boost or Toxicity Threat?. Nutrition Today 56(5):p 234-238, 9/10 2021. | DOI: 10.1097/NT.0000000000000500

A. Wretlind; Complete Intravenous Nutrition: Theoretical and Experimental Background. Nutrition and Metabolism 1 January 1972; 14 (Suppl. 1): 1–57. https://doi.org/10.1159/000175404