{"id":21816,"date":"2022-10-20T10:03:45","date_gmt":"2022-10-20T17:03:45","guid":{"rendered":"https:\/\/ameripharmaspe.wpengine.com\/?p=21816"},"modified":"2026-03-24T12:41:48","modified_gmt":"2026-03-24T19:41:48","slug":"total-parenteral-nutrition-tpn-complications","status":"publish","type":"post","link":"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/total-parenteral-nutrition-tpn-complications\/","title":{"rendered":"Bi\u1ebfn ch\u1ee9ng c\u1ee7a dinh d\u01b0\u1ee1ng qua \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch ho\u00e0n to\u00e0n (TPN)"},"content":{"rendered":"\n<p><span style=\"font-weight: 400;\">Total parenteral nutrition (TPN) is a feeding method that omits the gastrointestinal tract. Most of the body&#8217;s nutritional requirements are met by a specific formula that is administered intravenously. This technique is utilized when a person cannot receive feedings or fluids orally. A patient may require TPN permanently or temporarily, depending on the illness.&nbsp;<\/span><\/p>\n\n\n\n<div  id=\"call-to-action-a4234d0aef098817414ceea731dbbb26\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tIV Fluids Fully in Stock\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"cta__sub__heading\">\n\t\t\t\t\t\t\tReliable supply for uninterrupted care\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"#form\">Learn More<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<p><span style=\"font-weight: 400;\">Poor aseptic techniques and poor maintenance of TPN central lines can lead to severe TPN complications [1]. It has been reported that about 5% to 10% of patients receiving total parenteral nutrition (TPN) have experienced adverse side effects and long-term complications associated with central venous access (central lines) or TPN itself [2]. Healthcare professionals have reported the following TPN complications:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><span style=\"font-weight: 400;\">Catheter-associated complications<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Metabolic abnormalities<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Hepatic complications<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Metabolic bone disease<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Thrombosis (blood clots)<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Dehydration and electrolyte imbalances&nbsp;<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Infection<\/span><\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-full\"><img loading=\"lazy\" decoding=\"async\" width=\"1280\" height=\"864\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications.png\" alt=\"Diagram showing TPN complications\" class=\"wp-image-28112\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications.png 1280w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-300x203.png 300w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-1024x691.png 1024w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-768x518.png 768w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-18x12.png 18w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-600x405.png 600w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-86x58.png 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-167x113.png 167w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-280x189.png 280w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-370x250.png 370w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/tpn-complications-960x648.png 960w\" sizes=\"auto, (max-width: 1280px) 100vw, 1280px\" \/><\/figure>\n\n\n\n<h2 class=\"wp-block-heading\">Catheter-associated TPN Complications<\/h2>\n\n\n\n<p><span style=\"font-weight: 400;\">Catheter insertions are necessary for <\/span><a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/tpn-solution\/total-parenteral-nutrition-tpn-faq\/\"><span style=\"font-weight: 400;\">TPN<\/span><\/a><span style=\"font-weight: 400;\"> feedings and may lead to catheter-related problems. Two complications that most frequently arise are infections and catheter occlusions. However, these complications can be avoided by keeping the lines clean and using the catheter only for TPN.&nbsp;<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Other c<\/span><span style=\"font-weight: 400;\">omplications may include poor aseptic technique, contamination around the insertion area, and poor maintenance of central lines. <\/span><span style=\"font-weight: 400;\">Complications with central venous access affect 5% to 10% of individuals receiving TPN. The most frequent and potentially lethal <\/span><a href=\"https:\/\/link.springer.com\/article\/10.1007\/PL00012352\"><span style=\"font-weight: 400;\">catheter-associated complications<\/span><\/a><span style=\"font-weight: 400;\"> experienced by patients during TPN nutritional support include acute bacterial infections called <\/span><a href=\"https:\/\/my.clevelandclinic.org\/health\/diseases\/12361-sepsis\"><span style=\"font-weight: 400;\">sepsis<\/span><\/a><span style=\"font-weight: 400;\"> (bloodstream infection) and <\/span><a href=\"https:\/\/medlineplus.gov\/skininfections.html\"><span style=\"font-weight: 400;\">localized skin infections<\/span><\/a><span style=\"font-weight: 400;\"> at the insertion or exit point of the catheter [1, 2].&nbsp;<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Research statistics show that approximately 100,000 patients experienced 80\u2013189 episodes<\/span><span style=\"font-weight: 400;\"> of <\/span><span style=\"font-weight: 400;\">central line-associated bloodstream infection (CLABSIs) per <\/span><span style=\"font-weight: 400;\">year in the US due to poor aseptic techniques. The mortality rate of CLABSIs ranges between 12% to 25% of cases [3].&nbsp;<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Amateur insertion of catheters in the veins can result in air embolisms <\/span><span style=\"font-weight: 400;\">(which happens when an IV tube is left unclamped or removed without being clamped, leading to the formation of air bubbles in the vein), <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC4613416\/\"><span style=\"font-weight: 400;\">pneumothorax<\/span><\/a><span style=\"font-weight: 400;\"> (a condition in which your lungs collapse when the tip of a catheter enters into the pleural cavity), and <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC5606399\/\"><span style=\"font-weight: 400;\">thrombosis<\/span><\/a><span style=\"font-weight: 400;\"> (blockage of a vein due to blood clots or injury) [2]. According to TPN guidelines, practicing aseptic techniques of insertion or removal of the catheter can help avoid catheter-associated complications. [4]<\/span><\/p>\n\n\n\n<div  id=\"call-to-action-2ef0774fd4974cdeb8285dff54f3bd45\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tAmeriPharma\u00ae Specialty Care\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<span class=\"cta__sub__heading\">\n\t\t\t\t\t\t\tTotal Parenteral Nutrition | Leader In TPN Assistance\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"#form\">Schedule a Consultation<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Metabolic Abnormalities<\/h2>\n\n\n<div class=\"wp-block-image\">\n<figure class=\"alignright\"><img loading=\"lazy\" decoding=\"async\" width=\"420\" height=\"280\" src=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids.jpg\" alt=\"Patient drinking fluids\" class=\"wp-image-21819\" srcset=\"https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids.jpg 420w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-300x200.jpg 300w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-330x220.jpg 330w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-86x57.jpg 86w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-167x111.jpg 167w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-280x187.jpg 280w, https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2022\/10\/patient-drinking-fluids-370x247.jpg 370w\" sizes=\"auto, (max-width: 420px) 100vw, 420px\" \/><\/figure>\n<\/div>\n\n\n<p><span style=\"font-weight: 400;\">Approximately <\/span><a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2795374\/\"><span style=\"font-weight: 400;\">90% of patients receiving TPN administration<\/span><\/a><span style=\"font-weight: 400;\"> experience metabolic complications, specifically glucose abnormalities (hypoglycemia or hyperglycemia). <a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/tpn-solution\/metabolic-complications-of-tpn\/\">Metabolic complications<\/a> can be controlled by monitoring electrolytes, blood glucose levels, and insulin levels.&nbsp;<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Metabolic complications (abnormalities) may arise due to rapid infusion of nutrients after a recent malnourished state. Some of the major metabolic abnormalities include <\/span><a href=\"https:\/\/www.niddk.nih.gov\/health-information\/diabetes\/overview\/preventing-problems\/low-blood-glucose-hypoglycemia#:~:text=Low%20blood%20glucose%2C%20also%20called,deciliter%20(mg%2FdL).\"><span style=\"font-weight: 400;\">hypoglycemia<\/span><\/a><span style=\"font-weight: 400;\"> (which happens due to TPN discontinuation) or <\/span><a href=\"https:\/\/www.diabetes.org\/healthy-living\/medication-treatments\/blood-glucose-testing-and-control\/hyperglycemia#:~:text=Hyperglycemia%20is%20the%20technical%20term,can't%20use%20insulin%20properly.\"><span style=\"font-weight: 400;\">hyperglycemia<\/span><\/a><span style=\"font-weight: 400;\"> and <\/span><a href=\"https:\/\/ameripharmaspecialty.com\/other-health-conditions\/what-is-refeeding-syndrome\/\"><span style=\"font-weight: 400;\">refeeding syndrome<\/span><\/a><span style=\"font-weight: 400;\"> (severely malnourished patients experience this syndrome usually within 24 to 48 hours when <a href=\"https:\/\/ameripharmaspecialty.com\/conditions-treatments\/total-parenteral-nutrition-tpn\/\">TPN infusion<\/a> results in metabolic and hormonal changes characterized by electrolytes shift.) [5, 6] When starting TPN in previously malnourished patients, refeeding syndrome is caused by abrupt changes in fluid and electrolyte levels. Refeeding syndrome patients typically have low levels of phosphate, magnesium, and potassium. These symptoms may become exacerbated with <\/span><a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/tpn-solution\/\"><span style=\"font-weight: 400;\">TPN<\/span><\/a><span style=\"font-weight: 400;\">, largely caused by low levels of phosphate, leading to respiratory failure, convulsions, delirium, and death. It can also decrease cardiac contractility.<\/span><\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Hepatic Complications<\/h2>\n\n\n\n<p><span style=\"font-weight: 400;\">Total parenteral nutrition can result in a plethora of hepatic complications. Some of the hepatic complications include hepatic steatosis, gallbladder and bile duct damage, and cholestasis. The most serious consequence can lead to progressive fibrosis and cirrhosis, which is the most notable concern in long-term use of TPN in both adults and pediatric patients. Long-term TPN use can lead to low birth weight, sepsis, short bowel syndrome, and prematurity.&nbsp;<\/span><\/p>\n\n\n\n<p><span style=\"font-weight: 400;\">Hepatic complications are more prevalent in infants with immature liver but can occur at any age, affecting<\/span> <a href=\"https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC2795374\/\"><span style=\"font-weight: 400;\">15% to 40% of patients receiving total parenteral nutrition (TPN) infusion<\/span><\/a><span style=\"font-weight: 400;\">. Hepatic complications include liver dysfunction, increased ammonia levels, and painful hepatomegaly.&nbsp;<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><span style=\"font-weight: 400;\">Liver dysfunction commonly occurs due to&nbsp;an increased ratio of bilirubin and alkaline phosphatase, resulting in inflammation, cholestasis, and progressive fibrosis.<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Increased ammonia levels and painful <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/enlarged-liver\/symptoms-causes\/syc-20372167#:~:text=An%20enlarged%20liver%20is%20one,congestive%20heart%20failure%20or%20cancer.\"><span style=\"font-weight: 400;\">hepatomegaly<\/span><\/a><span style=\"font-weight: 400;\"> result in fat accumulation, feeling of twitching, seizures, and lethargy.<\/span><\/li>\n<\/ul>\n\n\n\n<p><span style=\"font-weight: 400;\">If you experience one of those symptoms, consult your doctor immediately. Healthcare professionals usually reduce protein delivery during these complications [5].&nbsp;<\/span><\/p>\n\n\n\n<div  id=\"call-to-action-a684303f838ecab5624380fd72a81de2\" style=\"\" class=\"ct_call_to_action\">\n\t<div class=\"container\">\n\t\t<div class=\"block-wrap cta\">\n\t\t\t<div class=\"block-column\">\n\t\t\t\t<div class=\"cta_headings\">\n\t\t\t\t\t\t\t\t\t\t\t<h4 class=\"cta__heading\">\n\t\t\t\t\t\t\tSpeak to a Specialist About Copay Assistance\t\t\t\t\t\t<\/h4>\n\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t\t\t\t\t\t<span class=\"cta_btn\">\n\t\t\t\t\t\t<a href=\"tel:8777780318\">(877) 778-0318<\/a>\n\t\t\t\t\t\t\t\t\t\t\t<\/span>\n\t\t\t\t\t\t\t<\/div>\n\n\t\t<\/div>\n\t<\/div>\n<\/div>\n\n\n\n<h2 class=\"wp-block-heading\">Metabolic Bone Disease<\/h2>\n\n\n\n<p><span style=\"font-weight: 400;\">Metabolic bone disease is a problem that can arise in long-term TPN use. <\/span><span style=\"font-weight: 400;\">Approximately 40% of the patient\u2019s receiving long-term TPN infusion experience metabolic bone diseases such as osteomalacia and <\/span><a href=\"https:\/\/www.mayoclinic.org\/diseases-conditions\/osteoporosis\/symptoms-causes\/syc-20351968#:~:text=Overview,being%20broken%20down%20and%20replaced.\"><span style=\"font-weight: 400;\">osteoporosis<\/span><\/a><span style=\"font-weight: 400;\">. This can lead to a decrease in quality of life due to bone pain, fractures, and limited mobility. However, the prevalence and pathogenesis of bone demineralization are still unclear [5]. The reported causes of these bone diseases can be due to:<\/span><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><span style=\"font-weight: 400;\">Less exposure to sunlight (low vitamin D intake)<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Lack of physical activity<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Side effects of other therapies such as heparin and steroids<\/span><\/li>\n\n\n\n<li><span style=\"font-weight: 400;\">Suboptimal intake of calcium, phosphate, and vitamin D<\/span><\/li>\n<\/ul>\n\n\n\n<p><span style=\"font-weight: 400;\">It has been demonstrated that intravenous pamidronate improves the bone mineral density of patients receiving TPN at home [7].<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dinh d\u01b0\u1ee1ng ngo\u00e0i \u0111\u01b0\u1eddng ti\u00eau h\u00f3a ho\u00e0n to\u00e0n (TPN) l\u00e0 ph\u01b0\u01a1ng ph\u00e1p nu\u00f4i d\u01b0\u1ee1ng kh\u00f4ng qua \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. H\u1ea7u h\u1ebft nhu c\u1ea7u dinh d\u01b0\u1ee1ng c\u1ee7a c\u01a1 th\u1ec3 \u0111\u01b0\u1ee3c \u0111\u00e1p \u1ee9ng b\u1eb1ng m\u1ed9t c\u00f4ng th\u1ee9c dinh d\u01b0\u1ee1ng \u0111\u1eb7c hi\u1ec7u \u0111\u01b0\u1ee3c truy\u1ec1n qua \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch. K\u1ef9 thu\u1eadt n\u00e0y \u0111\u01b0\u1ee3c s\u1eed d\u1ee5ng khi m\u1ed9t ng\u01b0\u1eddi kh\u00f4ng th\u1ec3 \u0103n ho\u1eb7c u\u1ed1ng b\u1eb1ng \u0111\u01b0\u1eddng mi\u1ec7ng.<\/p>","protected":false},"author":16,"featured_media":21817,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":true,"om_disable_all_campaigns":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[12],"tags":[21],"class_list":["post-21816","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tpn","tag-dr-martina-mikail"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Total Parenteral Nutrition (TPN) Complications<\/title>\n<meta name=\"description\" content=\"Learn about TPN complications and how to deal with them. 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