Complications of total parenteral nutrition in surgery

ABSTRACT

From May 95 to November,96 twenty two patients [18 males and 4 females] were on total parenteral nutrition [TPN] for more than seven days at West Surgical Unit, Mayo Hospital, Lahore and a note was made of the complications encountered specifically due to total parenteral nutrition. Fecal fistula was the leading indication for total paranteral nutrition [55%] and among them ilea] fistula was the commonest [66%]. Complications due to central venous line were encountered. Those resulting from total paranteral nutrition were hyperglycaemia, hypoglycaemia, hyponatracmia, apathy, fits, coagulopathy etc. One patient died [4%], 23% cases were abandoned half way and success rate was 68%. We noted complications tend to come on in "clusters". Also the lack of adequate monitoring was observed. Total Parenteral Nutrition should be given when gastrointestinal tract is unavailable, unreliable or being rested. Stress is laid upon monitoring Total Parenteral Nutrition delivery. Total Parenteral Nutrition is expensive but total parenteral nutrition is beneficial