Parenteral Nutrition

Parenteral Nutrition

a. Insertion site of permanent catheter

b. Exit site of catheter with an external segment. The implanted port is situated in the upper chest wall.

Parenteral Nutrition

Parenteral Nutrition (PN) is given via a dedicated catheter (CVC - central venous catheter) which is placed in a main vein. The tip of the catheter sits close to the heart.

The nutrients that the body requires are in a solution which is administered intravenously through the small permanent catheter. There are two types of catheter: one which has an external segment and one which is an implanted device although there are a variety of brands of catheters.

The catheter must be connected to the bag of nutrient solution under aseptic conditions, as the catheter tip lies approximately 3cm from the heart, minimising infection risks are important. All procedures carried out in relation to line care are designed to reduce the risk of allowing bacteria to be introduced into the bloodstream.

The normal volume infused is between 2 - 3 litres, but some may need larger volumes for a longer time and some people may require top up fluids. It is generally given over a 10 - 12 hour period, much of the infusion time is done overnight (this will depend upon individual volumes and rates.)

You will receive regular monitoring and be encouraged to interact with your team of healthcare professionals while your therapy is on-going.

Parenteral Nutrition (PN) is also referred to as ‘Total Parenteral Nutrition’ (TPN) and ‘Home Parenteral Nutrition’ (HPN)

Parenteral Nutrition via PICC Line

Parenteral Nutrition via PICC Line

Sometimes parenteral nutrition is given via a different type of line than a CVC and a PICC line or Peripherally Inserted Central Veneous Catheter is used.

A PICC line is similar to a CVC in that the internal tip is located at the top of the heart, but it enters the body via a vein in the middle of the arm and this is where the external port is located. 

Your healthcare team will make the decision on which type of line would be most suitable for you, taking many things into account, such as how long you are likely to require parenteral nutrition for, whether you have suitable sites for proper access, your medical history, etc.

The PICC line is used in much the same way as the CVC and still requires the use of an asceptic technique when accessing (which should be inline with your hospital/healthcare trust).

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