{"id":27239,"date":"2024-11-27T13:11:20","date_gmt":"2024-11-27T20:11:20","guid":{"rendered":"https:\/\/ameripharmaspecialty.com\/uncategorized\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/"},"modified":"2025-12-30T17:29:31","modified_gmt":"2025-12-31T00:29:31","slug":"understanding-the-link-between-tpn-and-transaminitis-causes-and-management","status":"publish","type":"post","link":"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/","title":{"rendered":"Hi\u1ec3u v\u1ec1 t\u00ecnh tr\u1ea1ng t\u0103ng men gan li\u00ean quan \u0111\u1ebfn vi\u1ec7c s\u1eed d\u1ee5ng TPN: Nguy\u00ean nh\u00e2n v\u00e0 c\u00e1ch x\u1eed l\u00fd."},"content":{"rendered":"\n<p>While TPN (total parenteral nutrition) can be life-saving for individuals with severe or long-term intestinal failure, it can also lead to a potentially life-threatening condition called transaminitis. Transaminitis is more commonly known as elevated liver enzymes.<\/p>\n\n\n\n<div  id=\"call-to-action-5669cf9ccff892a7f00e028a77892ab9\" 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\tAsk About TPN Home Infusion\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<p>In this article, we will discuss elevated liver enzymes in individuals receiving <a href=\"https:\/\/ameripharmaspecialty.com\/conditions-treatments\/total-parenteral-nutrition-tpn\/\">TPN therapy<\/a>.<\/p>\n\n\n\n<div id=\"ez-toc-container\" class=\"ez-toc-v2_0_82_2 counter-hierarchy ez-toc-counter ez-toc-custom ez-toc-container-direction\">\n<div class=\"ez-toc-title-container\">\n<span class=\"ez-toc-title-toggle\"><a href=\"#\" class=\"ez-toc-pull-right ez-toc-btn ez-toc-btn-xs ez-toc-btn-default ez-toc-toggle\" aria-label=\"Toggle Table of Content\"><span class=\"ez-toc-js-icon-con\"><span class=\"\"><span class=\"eztoc-hide\" style=\"display:none;\">Toggle<\/span><span class=\"ez-toc-icon-toggle-span\"><svg style=\"fill: #999;color:#999\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" class=\"list-377408\" width=\"20px\" height=\"20px\" viewBox=\"0 0 24 24\" fill=\"none\"><path d=\"M6 6H4v2h2V6zm14 0H8v2h12V6zM4 11h2v2H4v-2zm16 0H8v2h12v-2zM4 16h2v2H4v-2zm16 0H8v2h12v-2z\" fill=\"currentColor\"><\/path><\/svg><svg style=\"fill: #999;color:#999\" class=\"arrow-unsorted-368013\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\" width=\"10px\" height=\"10px\" viewBox=\"0 0 24 24\" version=\"1.2\" baseProfile=\"tiny\"><path d=\"M18.2 9.3l-6.2-6.3-6.2 6.3c-.2.2-.3.4-.3.7s.1.5.3.7c.2.2.4.3.7.3h11c.3 0 .5-.1.7-.3.2-.2.3-.5.3-.7s-.1-.5-.3-.7zM5.8 14.7l6.2 6.3 6.2-6.3c.2-.2.3-.5.3-.7s-.1-.5-.3-.7c-.2-.2-.4-.3-.7-.3h-11c-.3 0-.5.1-.7.3-.2.2-.3.5-.3.7s.1.5.3.7z\"\/><\/svg><\/span><\/span><\/span><\/a><\/span><\/div>\n<nav><ul class='ez-toc-list ez-toc-list-level-1 ' ><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-1\" href=\"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/#A_Quick_Overview_of_Elevated_Liver_Enzymes\" >A Quick Overview of Elevated Liver Enzymes<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-2\" href=\"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/#TPN_and_Transaminitis_Are_Elevated_Liver_Enzymes_Common\" >TPN and Transaminitis: Are Elevated Liver Enzymes Common?<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-3\" href=\"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/#How_TPN_Can_Cause_Elevated_Liver_Enzymes\" >How TPN Can Cause Elevated Liver Enzymes<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-4\" href=\"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/#TPN_and_Transaminitis_Strategies_To_Manage_Elevated_Liver_Enzymes_During_Long-Term_TPN_Therapy\" >TPN and Transaminitis: Strategies To Manage Elevated Liver Enzymes During Long-Term TPN Therapy<\/a><\/li><li class='ez-toc-page-1 ez-toc-heading-level-2'><a class=\"ez-toc-link ez-toc-heading-5\" href=\"https:\/\/ameripharmaspecialty.com\/vi\/tpn\/understanding-the-link-between-tpn-and-transaminitis-causes-and-management\/#Key_Points\" >Key Points<\/a><\/li><\/ul><\/nav><\/div>\n<h2 class=\"wp-block-heading\" id=\"h-a-quick-overview-of-transaminitis\"><span class=\"ez-toc-section\" id=\"A_Quick_Overview_of_Elevated_Liver_Enzymes\"><\/span><strong>A Quick Overview of Elevated Liver Enzymes<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Transaminitis, or elevated liver enzymes, occurs when the levels of one or both key liver enzymes, alanine transaminase (ALT) and aspartate transaminase (AST), are elevated above the normal range.<\/p>\n\n\n\n<p>ALT and AST belong to a family of enzymes called transaminases, or aminotransferases. The liver needs these enzymes to break down substances and remove toxic chemicals from the body.<\/p>\n\n\n\n<p>Transaminitis is not a disease; it is a sign of injury to the liver cells. Several conditions can cause elevated transaminases, such as:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Fat build-up in the liver<\/li>\n\n\n\n<li>Viral hepatitis<\/li>\n\n\n\n<li>Heavy drinking<\/li>\n\n\n\n<li>Liver damage due to certain medications<\/li>\n<\/ul>\n\n\n\n<p>Below, we will examine the occurrence of elevated liver enzymes in patients receiving total parenteral nutrition.<\/p>\n\n\n\n<p>Further Reading: <a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/tpn-and-liver-damage-a-comprehensive-overview\/\">TPN and Liver Damage: A Comprehensive Overview<\/a><\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-tpn-and-transaminitis-are-elevated-transaminases-common\"><span class=\"ez-toc-section\" id=\"TPN_and_Transaminitis_Are_Elevated_Liver_Enzymes_Common\"><\/span><strong>TPN and Transaminitis: Are Elevated Liver Enzymes Common?<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Can TPN cause elevated liver enzymes? An increase in blood transaminase levels is one of the most frequent TPN-associated issues. It typically occurs during the first 2 to 3 weeks after starting TPN [<a href=\"https:\/\/ccforum.biomedcentral.com\/articles\/10.1186\/cc5670\">1<\/a>].<\/p>\n\n\n\n<p>Other TPN-associated conditions include:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Steatosis (fatty liver)<\/li>\n\n\n\n<li>Cholestasis (slowed bile flow)<\/li>\n\n\n\n<li>Gallstones<\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-how-tpn-can-cause-transaminitis\"><span class=\"ez-toc-section\" id=\"How_TPN_Can_Cause_Elevated_Liver_Enzymes\"><\/span><strong>How TPN Can Cause Elevated Liver Enzymes<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>Several mechanisms are thought to cause liver injury during long-term TPN.<\/p>\n\n\n\n<p>People on long-term TPN therapy often have lower blood levels of choline. Choline deficiency is associated with both steatosis (fatty liver) and elevated transaminases [<a href=\"https:\/\/www.jandonline.org\/article\/S0002-8223(97)00161-2\/abstract\">2<\/a>][<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/11531217\/\">3<\/a>].<\/p>\n\n\n\n<p>Some studies suggest choline supplementation may help reverse these TPN-associated abnormalities.<\/p>\n\n\n\n<p>Also Read: <a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/tpn-and-cholestasis-7-frequently-asked-questions\/\">TPN and Cholestasis: 7 Frequently Asked Questions<\/a><\/p>\n\n\n\n<p>The risk of elevated liver enzymes may be higher in individuals receiving first-generation, soybean-based lipid preparations. In contrast, second-generation and third-generation preparations appear to carry a lower risk.<\/p>\n\n\n\n<p>In addition, minerals in TPN preparations, such as copper and manganese, may accumulate in the liver. An excess of these minerals can cause elevated liver enzymes and even liver damage.<\/p>\n\n\n\n<div  id=\"call-to-action-6d8c63b68771e060097565cc61eab2df\" 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\tGet Financial Assistance for TPN\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=\"#form\">Get Started<\/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\" id=\"h-tpn-and-transaminitis-strategies-to-manage-transaminitis-during-long-term-tpn-therapy\"><span class=\"ez-toc-section\" id=\"TPN_and_Transaminitis_Strategies_To_Manage_Elevated_Liver_Enzymes_During_Long-Term_TPN_Therapy\"><\/span><strong>TPN and Transaminitis: Strategies To Manage Elevated Liver Enzymes During Long-Term TPN Therapy<\/strong><span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<p>If you or anyone you love has TPN-associated elevated liver enzymes, your provider may [<a href=\"https:\/\/pmc.ncbi.nlm.nih.gov\/articles\/PMC5536778\/\">4<\/a>]:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Treat the underlying liver disease.<\/li>\n\n\n\n<li>Advise you to try avoiding medicines that can damage liver cells, such as antibiotics, pain medications, and certain herbal preparations.<\/li>\n\n\n\n<li>Treat bacterial overgrowth.<\/li>\n\n\n\n<li>Avoid overfeeding.<\/li>\n\n\n\n<li>Adjust the lipid (fat) content of the TPN formulation.<\/li>\n\n\n\n<li>Prescribe specific medications to reduce liver damage.<\/li>\n\n\n\n<li>Switch to enteral nutrition where possible.<\/li>\n<\/ul>\n\n\n\n<p>Your provider may also decide to administer intravenous nutrient solutions using a method called <a href=\"https:\/\/ameripharmaspecialty.com\/tpn\/what-is-cyclic-tpn\/\">cyclic TPN<\/a>. Unlike continuous TPN, this method offers your body a \u201cmetabolic\u201d rest, allowing your liver to heal.<\/p>\n\n\n\n<p>According to a 2017 study, cyclic TPN significantly reduces both ALT and AST levels [<a href=\"https:\/\/nutritionj.biomedcentral.com\/articles\/10.1186\/s12937-017-0289-7\">5<\/a>].<\/p>\n\n\n\n<p>Likewise, using SMOFlipid as part of the TPN formulation \u2014 an injectable lipid emulsion \u2014 can help reduce ALT and AST levels in children [<a href=\"https:\/\/scholarsrepository.llu.edu\/cgi\/viewcontent.cgi?params=\/context\/rr\/article\/1013\/&amp;path_info=smoflipid_chelsey_kara_shannon.pdf\">6<\/a>].<\/p>\n\n\n\n<h2 class=\"wp-block-heading\" id=\"h-key-points\"><span class=\"ez-toc-section\" id=\"Key_Points\"><\/span>Key Points<span class=\"ez-toc-section-end\"><\/span><\/h2>\n\n\n\n<ol class=\"wp-block-list\">\n<li>Transaminitis (elevated liver enzymes) is one of the most common TPN-associated complications.<\/li>\n\n\n\n<li>Other factors, such as heavy drinking and hepatitis, can also cause elevated liver enzymes.<\/li>\n\n\n\n<li>While transaminitis is not a disease, it is one of the earliest signs of liver injury.<\/li>\n\n\n\n<li>TPN-associated transaminitis is thought to occur, in part, due to choline deficiency.<\/li>\n\n\n\n<li>Several measures can help improve elevated liver enzymes. These include treating underlying liver disease, avoiding overfeeding, and switching to cyclic TPN.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>M\u1eb7c d\u00f9 TPN (dinh d\u01b0\u1ee1ng to\u00e0n ph\u1ea7n qua \u0111\u01b0\u1eddng t\u0129nh m\u1ea1ch) c\u00f3 th\u1ec3 c\u1ee9u s\u1ed1ng nh\u1eefng ng\u01b0\u1eddi b\u1ecb suy ru\u1ed9t n\u1eb7ng ho\u1eb7c m\u00e3n t\u00ednh, nh\u01b0ng n\u00f3 c\u0169ng c\u00f3 th\u1ec3 d\u1eabn \u0111\u1ebfn m\u1ed9t t\u00ecnh tr\u1ea1ng nguy hi\u1ec3m \u0111\u1ebfn t\u00ednh m\u1ea1ng g\u1ecdi l\u00e0 t\u0103ng men gan. T\u0103ng men gan th\u01b0\u1eddng \u0111\u01b0\u1ee3c bi\u1ebft \u0111\u1ebfn v\u1edbi t\u00ean g\u1ecdi men gan t\u0103ng cao.<\/p>","protected":false},"author":36,"featured_media":27238,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"om_disable_all_campaigns":false,"_uag_custom_page_level_css":"","footnotes":""},"categories":[12],"tags":[55],"class_list":["post-27239","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-tpn","tag-neil-marshall"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Understanding Elevated Liver Enzymes Related to TPN Administration: Causes &amp; Management<\/title>\n<meta name=\"description\" content=\"Learn how TPN can cause transaminitis, leading to elevated liver enzymes. 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B\u1ec7nh nh\u00e2n v\u00e0 sinh vi\u00ean g\u1ecdi \u00f4ng l\u00e0 Ti\u1ebfn s\u0129 Neil, v\u00ec \u00f4ng \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p k\u00e9p l\u00e0 m\u1ed9t chuy\u00ean gia ch\u00e2m c\u1ee9u \u0111\u01b0\u1ee3c c\u1ea5p ph\u00e9p v\u1edbi b\u1eb1ng Ti\u1ebfn s\u0129 v\u1ec1 Ch\u00e2m c\u1ee9u v\u00e0 Y h\u1ecdc Trung Qu\u1ed1c. Hi\u1ec7n \u00f4ng \u0111ang gi\u1ea3ng d\u1ea1y cho c\u00e1c h\u1ecdc vi\u00ean s\u1eafp ra tr\u01b0\u1eddng t\u1ea1i m\u1ed9t tr\u01b0\u1eddng \u0110\u1ea1i h\u1ecdc Y khoa Trung Qu\u1ed1c \u1edf Los Angeles. L\u00e0 m\u1ed9t b\u00e1c s\u0129 \u0111a khoa (PCP) t\u1ea1i California, \u00f4ng cung c\u1ea5p h\u01b0\u1edbng d\u1eabn v\u1ec1 dinh d\u01b0\u1ee1ng v\u00e0 c\u00e1c v\u1ea5n \u0111\u1ec1 li\u00ean quan \u0111\u1ebfn ch\u1ebf \u0111\u1ed9 \u0103n u\u1ed1ng. Ti\u1ebfn s\u0129 Neil l\u00e0 c\u1ef1u th\u00e0nh vi\u00ean c\u1ee7a \u1ee6y ban An to\u00e0n ASPEN ph\u1ee5 tr\u00e1ch ph\u00e1t tri\u1ec3n c\u00e1c ti\u00eau chu\u1ea9n\/h\u01b0\u1edbng d\u1eabn v\u1ec1 dinh d\u01b0\u1ee1ng ngo\u00e0i \u0111\u01b0\u1eddng ti\u00eau h\u00f3a. Xu\u1ea5t th\u00e2n t\u1eeb v\u00f9ng Trung T\u00e2y, Ti\u1ebfn s\u0129 Neil hi\u1ec7n \u0111ang s\u1ed1ng t\u1ea1i California. Ngo\u00e0i gi\u1edd l\u00e0m vi\u1ec7c, anh th\u00edch d\u00e0nh th\u1eddi gian cho gia \u0111\u00ecnh, b\u1ea1n b\u00e8 v\u00e0 l\u00e0m x\u00e0 ph\u00f2ng th\u1ee7 c\u00f4ng.","url":"https:\/\/ameripharmaspecialty.com\/vi\/author\/neil-marshall\/"}]}},"uagb_featured_image_src":{"full":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"thumbnail":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-150x150.jpg",150,150,true],"medium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-300x200.jpg",300,200,true],"medium_large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-768x512.jpg",768,512,true],"large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-1024x682.jpg",1024,682,true],"1536x1536":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"2048x2048":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"trp-custom-language-flag":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",18,12,false],"block-image-html-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-600x400.jpg",600,400,true],"ct-gallery":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-330x220.jpg",330,220,true],"ct-section-header":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-1146x380.jpg",1146,380,true],"ct-thumb":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-86x57.jpg",86,57,true],"ct-thumb-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-167x111.jpg",167,111,true],"ct-small":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-280x187.jpg",280,187,true],"ct-medium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-370x247.jpg",370,247,true],"ct-xmedium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-960x640.jpg",960,640,true],"ct-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false]},"uagb_author_info":{"display_name":"Neil Marshall, DACM, BSN, LAc, RN, CRNI, NCCAOM\u00ae","author_link":"https:\/\/ameripharmaspecialty.com\/vi\/author\/neil-marshall\/"},"uagb_comment_info":0,"uagb_excerpt":"While TPN (total parenteral nutrition) can be life-saving for individuals with severe or long-term intestinal failure, it can also lead to a potentially life-threatening condition called transaminitis. Transaminitis is more commonly known as elevated liver enzymes.","rttpg_featured_image_url":{"full":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"landscape":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"portraits":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"thumbnail":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-150x150.jpg",150,150,true],"medium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-300x200.jpg",300,200,true],"large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-1024x682.jpg",1024,682,true],"1536x1536":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"2048x2048":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false],"trp-custom-language-flag":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",18,12,false],"block-image-html-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-600x400.jpg",600,400,true],"ct-gallery":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-330x220.jpg",330,220,true],"ct-section-header":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-1146x380.jpg",1146,380,true],"ct-thumb":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-86x57.jpg",86,57,true],"ct-thumb-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-167x111.jpg",167,111,true],"ct-small":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-280x187.jpg",280,187,true],"ct-medium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-370x247.jpg",370,247,true],"ct-xmedium":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient-960x640.jpg",960,640,true],"ct-large":["https:\/\/ameripharmaspecialty.com\/wp-content\/uploads\/2025\/04\/tpn-transaminitis-nurse-patient.jpg",1280,853,false]},"rttpg_author":{"display_name":"Neil Marshall, DACM, BSN, LAc, RN, CRNI, NCCAOM\u00ae","author_link":"https:\/\/ameripharmaspecialty.com\/vi\/author\/neil-marshall\/"},"rttpg_comment":0,"rttpg_category":"<a href=\"https:\/\/ameripharmaspecialty.com\/vi\/category\/tpn\/\" rel=\"category tag\">TPN<\/a>","rttpg_excerpt":"While TPN (total parenteral nutrition) can be life-saving for individuals with severe or long-term intestinal failure, it can also lead to a potentially life-threatening condition called transaminitis. Transaminitis is more commonly known as elevated liver enzymes.","_links":{"self":[{"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/posts\/27239","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/users\/36"}],"replies":[{"embeddable":true,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/comments?post=27239"}],"version-history":[{"count":0,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/posts\/27239\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/media\/27238"}],"wp:attachment":[{"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/media?parent=27239"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/categories?post=27239"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ameripharmaspecialty.com\/vi\/wp-json\/wp\/v2\/tags?post=27239"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}