How long can a person stay on TPN?

[lsvalliant]

I have a peds patient who has been on TPN since birth. I heard from his mother that if they dont wean him off of TPN by age two, it could seriously do damage to his liver and eventually cause his death. Is it two years for the adult population then too? Does the age and health of the liver affect the amount of time?

[K+MgSO4, BSN]

We send short gut syndrome patients home on home TPN. not sure how long they survive, it is pretty sore on the body and I'd say even more so on a developing child. Do you have a TPN pharmacist or Dietican who you can talk to or someone of the Gastro Docs?

[NRSKarenRN, BSN, RN]

although there may be consequences of long term tpn, i've cared for children and adults on tpn for over 10+ years. patients+ families that follow specialist advice, don't refuse lab work, don't change infusion rate or forget to give lipids , have scrupoulus catheter care provided, and compliant with physicians appointments do well--- most longterm complications can be minimized --depending on disease process.

parenteral nutrition - wikipedia, the free encyclopedia

long-term pn is occasionally used to treat people suffering the extended consequences of an accident, surgery, or digestive disorder. pn has extended the life of children born with nonexistent or severely deformed organs. people have survived on total parenteral nutrition for more than 35 years, living fully productive lives.

lecture: pediatric tpn

medscape nursing -free registration required

hospital to home care: discharge planning for the patient requiring home infusion therapy

pediatric short bowel syndrome: emedicine pediatrics: general medicine

total parenteral nutrition (tpn)

complications of long-term home total parenteral nutrition

[lsvalliant]

Thank you for your responses. The patient is very health and is age appropriate for development.. awaiting transplant. I was curious because the 2 year mark is approaching quickly. I was very happy to hear that some of you have had long term cases on TPN.

[Roslyn Dahl]

There is loads of great information on providing long term parenteral nutrition available from the Oley Foundation (patient organization, http://www.oley.org) and Association for Parenteral and Enteral Nutrition (clinician organization, http://www.nutritioncare.org/).

The Oley Foundation serves thousands of patients, and knows of hundreds of patients that have survived on TPN for more than 20 years. Most of them live fully productive lives.

If the child is on the transplant list because of liver issues, check out the research on Omegaven (Dr. Puder, Boston Childrens), and other recent research (from Mayo Clinic and a team from Ann Arbor, MI, I believe) on simply reducing the amount and frequency of Intralipid given. There have been promising results.

The links I recommend most on the Oley site are:

information on SBS, diet and hydration http://www.oley.org/Diet_Hydration_Nutrition.html

overview of Oley programs http://www.oley.org/programs.html

materials for clinicians http://www.oley.org/Clinician_Materials.html