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Hyperalimentation

Alternate Names

  • total parental nutrition
  • TPN
  • central hyperalimentation
  • parental hyperalimentation

Definition

Hyperalimentation is a procedure in which nutrients and vitamins are given to a person in liquid form through a vein. It is only given to someone who cannot get nutrients through the intestinal tract.

Who is a candidate for the procedure?

Hyperalimentation is used for people with health problems that prevent them from absorbing enough nutrients through their intestines. It is also used when a person is severely malnourished and cannot take in food by mouth. Hyperalimentation might be used:
before surgery if the person is malnourished. This can be caused by:
    • congenital abnormalities causing disorders of the gastrointestinal (GI) tract, such as esophageal atresia
    • esophageal stricture, which is a narrowing of the esophagus
    • esophageal cancer or stomach cancer
    • swallowing difficulties
after surgery if a person is not recovering as quickly as expected or has complications relating to the surgery. This can be caused by:
    • prolonged ileus, when the intestines are not awake or functioning
    • short bowel syndrome, which occurs after someone has large amount of small intestines removed
    • a fistula, an abnormal passageway between two internal organs, or leading from an internal organ to the surface of the body
    • peritonitis, a severe infection in the abdominal cavity
if a person has inflammatory bowel disease, including:
    • severe gastroenteritis
    • Crohn's disease
    • ulcerative colitis
    • extensive diverticulitis
if a person cannot eat or is unable to absorb nutrients from food. This may be caused by:
    • cancer of the GI tract, such as colon cancer
    • chemotherapy or radiation therapy
    • major trauma, such as a motor vehicle accident
    • massive burns
    • coma
    • an eating disorder called anorexia nervosa

How is the procedure performed?

A central line is a special intravenous or IV line that is inserted through the chest and threaded into one of the large veins that lie close to the heart. A central line must be used for this procedure because the solution is highly concentrated and would burn the tissues if it leaked out of an IV site, such as in the arm.
The hyperalimentation solution is tailored to the needs of the individual, and contains:
  • glucose, or sugar
  • amino acids, the digested form of proteins
  • electrolytes, such as potassium and sodium
  • vitamins
  • fat emulsion

Sources

Williams, Sue, Nutrition and Diet Therapy, 7th edition, 1993

Clinical Nutrition: Enteral and Tube Feeding, 2nd edition, 1990

Mosby's Clinical Nursing, 4th edition, 1994

Critical Care Nursing: A Holistic Approach, 6th edition, 1990

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