Parenteral Nutrition Dietitian and Nutritionist

Important information on parenteral nutrition by our registered dietitians:

What is parenteral nutrition?

Parenteral nutrition is the practice of intravenous (IV) feeding. It involves feeding a person directly through their bloodstream via an elemental fluid formula, bypassing their digestive system completely.

Types

There are two main types of parenteral nutrition: there is partial parenteral nutrition (PPN) and total parenteral nutrition (TPN). PPN is used to supplement oral intake, whereas TPN completely replaces oral/enteral nutrition.

IV feeding solutions contain the broken-down, molecular forms of protein (amino acids), carbohydrates (glucose) and fat (lipids), so that they can be utilized by cells as soon as they enter the bloodstream.

IV feeding solutions will also have added vitamins and minerals to ensure that micronutrient needs are being met as well.

The macro and micro nutrient content of an IV feed will be calculated and personalized to each individual and their nutritional needs/status.

Similarly to enteral nutrition, there are different types of IV feeds that can be inserted in various parts of the body.

Peripheral parenteral nutrition involves a less concentrated IV feed going through a person’s peripheral vein, such as in their arm.

Central parenteral nutrition involves a more concentrated IV feed going through a main vein (i.e. CVC – Central Venous Catheter; or PICC–Peripherally Inserted Central Catheter).

Like enteral nutrition, the route of IV feeds will depend on the duration of the feed. Peripheral parenteral nutrition is typically used in short-term implications, whereas central parenteral nutrition is used for long-term or chronic implications.

Short-term parenteral nutrition is often used to quickly boost a person’s nutritional intake before they transition to tube feeding and/or oral intake, in order to restore nutritional status and prevent deficiencies/complications.

Long-term parenteral nutrition can be used for people experiencing side effects of cancer/cancer treatment, severe IBD, intestinal blockage, post-invasive surgery, etc.

For these reasons the guidance of a dietitian for parenteral nutrition is critical.

A dietitian and nutritionist for parenteral nutrition can help in the following ways:

 

• Frequently, the formulas for IV feeds are calculated by a registered dietitian (RD).
• A dietitian, therefore, plays a very integral role in parenteral nutrition and ensuring that a person’s nutritional needs are met.
• Working alongside a medical team, a dietitian can help to make any adjustments to IV feeds as well.
• A dietitian for parenteral nutrition can assess your specific nutritional needs and recommend the best formula to meet your needs.
• Provide education on matters pertaining to parenteral nutrition, if desired.
• Help manage possible complications.
• Help manage possible gastrointestinal concerns.
• Assess and manage hydration needs.
• Monitor body weight, as well as any risks for malnutrition or weight gain.
• Provide support and guidance to achieve optimal health.
• Create personalized feeding regimen which takes into account any other health conditions and lifestyle factors.
• Provide follow-up sessions to monitor progress, address additional concerns and answer questions, if necessary.
• And more.