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PENG A5 Parenteral Nutrition 4 Pager_Layout 1 18/05/2016 09:07 Page 1
Parenteral
Nutrition
your questions answered
This leaflet has been put together to answer
some of the questions that you may have, Central
parenteral
if your healthcare professional has advised nutrition
you that you need parenteral nutrition.
Peripheral
parenteral
nutrition
PENG A5 Parenteral Nutrition 4 Pager_Layout 1 18/05/2016 09:07 Page 2
PARENTERAL NUTRITION – YOUR QUESTIONS ANSWERED
What is parenteral nutrition? If the gut is not working you may hear
Parenteral nutrition is an artificial way to give the term ‘intestinal failure’ being used.
your body nutrition (food) and hydration (fluid), • Because of your medical condition, you
when you are unable to eat/drink enough to may not be able to eat and drink anything
maintain your weight and hydration normally, at all, or even if you are able to eat and drink
or when you are not able to absorb enough you may not be able to ‘absorb’ enough from
nutrition from food and drink. what you eat and drink to obtain all your
Parenteral nutrition is a means of giving body needs from the food and drink that
your body some or all of the nutrition that it you take.
needs every day when you cannot obtain all In both situations the need for parenteral
the nutrition you need by other routes i.e. nutrition can be temporary (days or weeks) or
by mouth or tube feeding via the gut. long-term (months or years).
Parenteral nutrition involves administering Who will be involved in my care?
a specially formulated nutrient rich liquid When you are on parenteral nutrition you
directly into your bloodstream, by-passing your may be looked after by many types of health
gastrointestinal system (stomach, small bowel care professionals. The roles will vary between
and large bowel). The specially prepared liquid hospitals.
contains the nutrients your body needs. If you Your consultant will make the decisions
are receiving all your nutrition into your vein about what type of feeding you are able to
(and not from any other way) the parenteral have. This might include oral diet (food and
nutrition might also be referred to as total drinks), enteral tube feeding (tube feeding into
parenteral nutrition (TPN). your gut) or parenteral nutrition (feeding directly
How is parenteral nutrition given? into your vein).
Parenteral nutrition is given intravenously The junior doctors on the ward may take
through fine tubing and a catheter dedicated blood and prescribe extra medication related
to the purpose of feeding only. The fine tube to your feeding such as vitamins.
used to access the vein is often called a ‘line’. The nurses on the ward will look after
The liquid is administered with the use of an your day-to-day care; however, you may also
electronic intravenous feeding pump at a rate meet specialist nurses who look after your
chosen by the healthcare team. intravenous catheter (feeding line in your vein)
Why do I need parenteral nutrition? and other aspects of your nutrition.
Your dietitian will determine your nutritional
There are several reasons why you may need needs and order your parenteral nutrition bag.
parenteral nutrition. They will monitor the effects of the parenteral
• Your gastrointestinal tract may not be
nutrition and suggest changes to the content
functioning properly. This could be due to as required.
a number of reasons including long-term Your pharmacistwill advise on the content
health conditions or after gut surgery.
of your bag and ensure the mixture is safe to
PENG A5 Parenteral Nutrition 4 Pager_Layout 1 18/05/2016 09:07 Page 3
PARENTERAL NUTRITION – YOUR QUESTIONS ANSWERED
give through your feeding line. They will advise cannula’, or ‘mid-line catheter’. This method
on any other drug interactions. of feeding might be referred to as peripheral
You might be under the care of these parenteral nutrition (PPN).
professionals who work together as part of For medium term feeding it is more
a Nutrition Team. common to be fed into a larger, central
What are the benefits for me? vein. This could be through a peripherally
If you have intestinal failure you will be unable inserted central catheter (PICC) or a Hickman/
to absorb enough nutrition from food to meet Broviac line.
A central venous catheter (CVC), which
your daily needs. Parenteral nutrition will allow includes a PICC line, multi-lumen central line
you to have fluid and nutrition through your or Hickman line, is a long fine hollow tube
feeding line. Some people will have everything with an opening at each end. One end
they need through their parenteral nutrition, provides access from outside your body to
whereas, some people will only need to ‘top up’ the other end which is situated in a large vein
the nutrition that they have by mouth. in the body.
How long will I need parenteral For long term feeding, a Hickman or
nutrition? PICC line is usually inserted. These lines
can remain in position for several months
This will depend on the reason why you or years. The line is only to be used for the
need parenteral nutrition. You will be closely administration of your parenteral nutrition.
monitored to ensure you receive it for as Who will care for my line?
long as you need it.
Will I still be able to eat and drink? Nursing staff that have been trained will care
for your line. Medical and nursing staff that
Your consultant, dietitian or nutrition team have not been trained must not access your
member will be able to advise whether you can line. Please contact your Nutrition Nurse for
eat and drink, and if so, the types of foods advice.
and drinks that may be suitable. Their advice If you need parenteral nutrition for a long
will be based on the reason why you need time, a discussion with your Nutrition Nurse
parenteral nutrition and your needs. Specialist will take place about receiving your
What type of line will I have? parenteral nutrition at home. You may receive
There are several different types of lines used specialised nursing support at home, or you
for feeding into the blood stream (intravenous or your carer will be trained to manage your
access). You may have a line placed in a vein parenteral nutrition at home. Training can take
in your arm, neck or chest. 2-3 weeks or sometimes longer.
In hospital you might be fed into a small What can go wrong and what to look
vein (peripheral feeding). This is usually only out for
for short term feeding, i.e. less than 14 days. It is possible for an infection to develop
The line may be referred to as a ‘peripheral either inside the line or around the exit site.
PENG A5 Parenteral Nutrition 4 Pager_Layout 1 18/05/2016 09:07 Page 4
PARENTERAL NUTRITION – YOUR QUESTIONS ANSWERED
Symptoms may include: If you need longer term feeding at home,
• the exit site becomes red, swollen or painful. you will need to have supplies of parenteral
• you notice discoloured fluid coming from the nutrition and equipment where you live.
exit site. A company will deliver the equipment and
• you have a temperature. your bags of parenteral nutrition. You will be
• have shivers (rigors) when flushing your line provided with a fridge to store the parenteral
or during your parenteral nutrition infusion. nutrition at the correct temperature. Your
Other problems may include blood clots, Nutrition Nurse/Nutrition Team will arrange
air in the line, a break or cut in the line, a this for you.
blockage in the line. If you are worried speak Long term complications
to a member of staff on the ward. If you are Long term complications of parenteral nutrition
at home, contact a member of your Nutrition can include imbalances of fluid, salts and
Team or visit Accident and Emergency at minerals, high and low blood sugars, and
your local hospital. You will be taught what liver problems. Complications can arise from
to look for and how to respond. overfeeding and underfeeding. Your nutrition
How will it affect my life? support team will monitor you closely and
Your Dietitian and/or Nutrition Nurse will manage complications should they arise.
work with you to understand your normal What if I don’t want parenteral
routine and how feeding can be introduced nutrition?
with as little disruption as possible. To begin The decision to have parenteral nutrition can
with, it is likely that you will be fed over only be made by you and you should be given
24 hours. Usually this can be adjusted and all the information you need to help you make
you can feed over a shorter time period, a decision. Please ask your Nutrition Team
e.g. overnight. member as many questions as you need to.
This patient information leaflet has been produced by PENG with the support of the NNNG, PINNT and the BDA
Further questions, please contact: Name:
Job title: Tel/email:
Further information leaflets are available on the PINNT website: www.pinnt.com
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