TPN ramp up, ramp down meaning

[SleeepyRN]

Hi everyone. I tried looking this up on my own, but couldn't find out. I recently started working at a sub acute rehab facility where we have a LOT of patients on TPN. On the bag it read something like 1000 ml, infuse over 12 hours, ramp up, ramp down per hour. Does this mean that when setting the IV pump, the TPN will infuse at varying rates throughout the 12 hour period, or am I way off. What does ramp up, ramp down mean? Thanks in advance if anyone can advise. :-)

[nynursey_]

At my facility, it's referred to as "cycling." It typically is programmed into the pump per the specific TPN order. It changes the infusion rate over a period of time. If I'm not mistaken it's typically used to avoid hypoglycemia in people not taking PO where TPN is the only means of nutritional support.

[SleeepyRN]

Thank you so much! That makes perfect sense now

[morte, LPN, LVN]

the rate is started low, and "ramps" up over the first hour and then 'ramps" down in the last hour.

[Here.I.Stand, BSN, RN]

I too was thinking it meant cyclic rate, where it starts and ends at a slower rate. The exact rates and times are always specified in the Rx, though. Is there no other direction than "ramp up/ramp down"? If not, it needs to be clarified. If TPN requires two nurses to check, asking someone to assume the rate is asking for trouble.