From the Guidelines
Total Parenteral Nutrition (TPN) is a specialized intravenous solution that provides complete nutritional support for patients who cannot receive adequate nutrition through the gastrointestinal tract, typically containing macronutrients such as dextrose, amino acids, and lipid emulsions, as well as micronutrients including electrolytes, vitamins, and trace elements, with the exact composition individualized based on the patient's nutritional requirements, metabolic status, and clinical condition, as recommended by the most recent ESPEN guideline on home parenteral nutrition 1. The content of TPN includes:
- Macronutrients:
- Dextrose (providing 3.4 kcal/g) for carbohydrates
- Amino acids (providing 4 kcal/g) for protein
- Lipid emulsions (providing 9 kcal/g) for essential fatty acids and additional calories
- Micronutrients:
- Electrolytes (sodium, potassium, calcium, magnesium, phosphate, chloride)
- Vitamins (both water-soluble and fat-soluble)
- Trace elements (zinc, copper, manganese, chromium, selenium) The exact composition of TPN is individualized based on the patient's nutritional requirements, metabolic status, and clinical condition, with standard adult TPN formulations typically providing 25-35 kcal/kg/day with 1.2-2.0 g/kg/day of protein, as suggested by the ESPEN guidelines on parenteral nutrition 1. Regular monitoring of metabolic parameters, electrolytes, and blood glucose is essential during TPN administration to prevent complications such as refeeding syndrome, hyperglycemia, or electrolyte imbalances, as recommended by the American Gastroenterological Association medical position statement on short bowel syndrome and intestinal transplantation 1. TPN must be administered through a central venous catheter due to its high osmolarity, which can damage peripheral veins, and the infusion should be compressed to overnight, typically during a 10-hour period with an additional 30-60 minute taper period, as suggested by the ESPEN guidelines on parenteral nutrition 1.
From the FDA Drug Label
For total parenteral nutrition 50% Dextrose Injection, USP is administered by slow intravenous infusion (a) after admixture with amino acid solutions via an indwelling catheter with the tip positioned in a large central vein, preferably the superior vena cava, or (b) after dilution with sterile water for injection The content of Total Parenteral Nutrition (TPN) includes:
- Dextrose: 50% Dextrose Injection, USP
- Amino acid solutions: admixed with dextrose for TPN
- Sterile water for injection: used for dilution of dextrose for TPN 2
From the Research
Total Parenteral Nutrition (TPN) Content
The content of Total Parenteral Nutrition (TPN) includes:
- Macronutrients: carbohydrates, proteins, and fats 3, 4
- Micronutrients: vitamins, minerals, and trace elements 4, 5
- Electrolytes: to maintain proper balance of fluids and electrolytes in the body 4, 6
- Water: to meet the patient's hydration needs 4
Components of TPN
The components of TPN may vary depending on the individual patient's needs, but typically include:
- Dextrose: as a source of carbohydrates 4, 5, 6
- Amino acids: as a source of protein 4, 5, 6
- Intravenous fat emulsions (IVFE): as a source of fat 5, 6
- Vitamins and trace minerals: to meet the patient's micronutrient needs 4, 5, 6
Considerations for TPN Formulation
When formulating TPN, healthcare professionals must consider: