What in the world is TPN?

After reading Eric's entry about Day +1 (GCSF) you are probably wondering what is TPN.

TPN (Total Parenteral Nutrition) is kind of what the rest of the world would consider a feeding tube. Kevin is being supplemented through a tube that is connected to his hickman line they put in his chest last week. This is also how he received his chemo drugs with the exception of the vincristine which is a tiny pill this past week.

What exactly is TPN?
TPN bypasses the normal way the body digests food in the stomach. It supplies the fuels the body needs directly into the blood stream through a central IV line. The body needs 3 kinds of fuel — carbohydrates, protein, and fat.
• Carbohydrates provide calories to the body. They supply most of the energy or fuel the body needs to run. The main energy source in TPN is dextrose (sugar).
• Protein is made up of amino acids, which are the “building blocks” of life. The body uses protein to build muscle, repair tissue, fight infections, and carry nutrients through the body.
• Fat or Lipids are another source of calories and energy. Fat also helps carry vitamins in the blood stream. Fat supports and protects some of your organs and insulates your body against heat loss. Fat is white in color.
TPN also contains other nutrients, such as vitamins and minerals, electrolytes, and water.
• Vitamins added to the TPN provide the needed daily amounts of vitamins A, B, C, D, E, and K. It is the vitamins that are added to the TPN mixture that turns it yellow. The body also needs minerals. These minerals are zinc, copper, chromium, manganese, and selenium. The vitamins and minerals in the TPN are needed for the body’s growth and good health.
• Electrolytes are important for bone, nerve, organ, and muscle function. Electrolytes, such as calcium, potassium, phosphorus, magnesium, sodium, chloride, and acetate, are also added to the TPN mixture.
• Water is a vital part of TPN. It prevents patients from becoming dehydrated (too little fluid). The amount of water in the TPN is based on your child’s height and weight.
Staff members will use blood tests to check the balance of all the TPN parts. The most critical of these tests is the chemistry test that your child will have during each clinic visit. The TPN mixture may be changed based on your child’s needs and the blood test results.

Possible TPN–related problems
Some problems might occur when your child is on TPN. Sometimes the problem can be fixed by changing the levels of protein, carbohydrates, or electrolytes in the TPN mixture. The clinical pharmacist and the nutritionist will review all of your child’s blood tests daily and will correct any imbalances. Hyperglycemia, or too much blood sugar, is one of the problems that can occur while your child is receiving TPN. This imbalance does not happen often, but you should be aware of it.
Hyperglycemia (High blood sugar)
Hyperglycemia is a higher than normal level of sugar in the blood.
• It can happen when TPN is given too fast or if the body cannot accept the sugar. Sometimes having an infection or taking a medicine such as a steroid will make the body unable to use large amounts of sugar.
• Your child may have a headache or feel thirsty, weak, or sick to her stomach.
• The pharmacist and nutritionist will follow your child’s daily blood tests very closely. One of those tests checks the sugar level in the blood.


And yes, I am completely freaked out about doing this by myself with a screaming 8 month old in the back ground on a daily basis. I feel like I should have gone to nursing school. I don't remotely feel qualified for all of this.

Please pray that Kevin stays healthy through all of this.

Rachel