Nutrition
Patient Information
Parenteral nutrition:
information for adult patients
You have been referred for parenteral nutrition (PN). This leaflet will help you to understand what
this is and how it may affect you.
What is parenteral nutrition?
Parenteral nutrition (PN) is an alternative way of providing food for your body without you having
to eat or drink. All the nutrients you require will be given directly into your bloodstream via one of
your veins.
PN is used for one of the following reasons:
 Your gut cannot absorb enough food and drink to keep you in good health
 Your gut may need a period of rest to allow it to recover from surgery or disease
You will be told which of these reasons apply to you. PN may also be referred to as total
parenteral nutrition (TPN) or intravenous nutrition (IVN).
How is food given into the vein?
Sometimes a small, sterile tube (called a catheter) will be inserted into one of the large veins near
your heart. Sometimes a PICC (peripherally-inserted central catheter) will be used. This is where
a fine, long, plastic tube is inserted into a vein in your upper arm. It is then moved up inside the
vein to sit in a large vein near your heart. Both procedures are often carried out under a mild
sedative with local anaesthetic to minimise any pain or discomfort. A chest X-ray is taken to
confirm the position of the tube before PN can start.
PN contains all the nutrients your body needs. It contains:
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Protein (amino acids) for the growth and maintenance of your tissues
Glucose and fat for energy
Electrolytes such as sodium and calcium for bones
Vitamins and trace minerals
All of these are essential for growth and health.
A complex mixture of these nutrients is chosen to meet your individual requirements. The PN
mixture is combined in 2-3 litres of sterile water in a large plastic container. (This is sometimes
called a ‘drip feed’.) Each feed is prepared for you in a sterile or aseptic room.
How will this affect me?
Most patients only need PN for a week or two but some patients may need it for several months.
When PN is started in hospital, each bag is usually given over a 24-hour period (throughout the
day and night). If you have PN for more than two weeks and everything is stable, the feeding
time may be reduced gradually so that you can be ‘free’ of the feed for some time during the day.
The nutrition support team (NST) will come to see you at least twice a week. The team consists
of a dietitian, a nurse, a doctor and a pharmacist. The NST will also liaise with your usual
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hospital team to ensure that all your requirements are met and that everyone is kept fully
informed of your progress.
For the first week or so you will probably need to have blood tests every day. When the NST are
happy that your results are stable, this may change to once or twice a week.
You will also be weighed regularly. This is important so the team can assess that you are
receiving enough calories and that you are maintaining your weight. It will also give us an idea of
how well-nourished and hydrated you are.
Nurses will also check your blood sugar levels with a finger pinprick test to see how well you are
tolerating your PN. This will be checked most frequently in the first few days of treatment.
Occasionally, patients on PN develop raised blood sugar levels and require insulin to reduce
these to normal levels. The insulin will usually be stopped when the PN is no longer required.
While you are on PN you may not feel hungry or thirsty at all. This is because PN is continuously
providing all your daily requirements. If your gut is working a little, you may also be allowed to
eat and drink but we will explain this to you. When you start to eat larger amounts again, the PN
content may be changed slightly to encourage you to eat, or the drip may be run over fewer
hours.
What happens to my bowels during PN?
Even when no food is being passed through the gut, bowel movements will still occur because of
the mucus, cells and bacteria working there. There is usually a change in the amount and colour
of the stools produced.
As PN goes straight into the bloodstream, it does not cause diarrhoea, tummy pain or vomiting. If
any of these problems occur, please inform your nursing staff.
Are there any other problems I need to know about?
The majority of PN patients begin eating normally after a few weeks and go on to make an
uneventful recovery. However, as the catheter that enables you to have PN goes directly into
your bloodstream, it is important that you look out for signs of infection. If you develop a fever
(high temperature), or there is redness or swelling around the insertion site of the tube, please tell
the nursing staff or a doctor as soon as possible. This may mean you have an infection and you
may need antibiotics or the tube might need to be removed.
When will the PN be stopped?
PN is stopped when you can be given adequate nutrition by diet, or by tube-feeding if necessary.
The PN is usually reduced over a few days before it is stopped completely.
References
Adapted with permission from a leaflet by the British Pharmaceutical Nutrition Group (BPNG)
‘Peripherally-inserted central catheter’ – patient information leaflet from Poole Hospital NHS
Foundation Trust
Contact details
If you have any other worries or questions, please do not hesitate to ask the medical, nursing,
pharmacy staff or the members of the nutrition support team (NST) who have seen you. Please
contact:
Adult dietitians
Telephone: 01202 442687
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For further general health-related information, please ask the relevant department for an
Information Prescription or contact:
The Health Information Centre
Poole Hospital NHS Foundation Trust
Longfleet Road
Poole
Dorset
BH15 2JB
Telephone: 01202 448003
www.poole.nhs.uk
Author: D. Terrot and S. Williams from NST
Date: May 2014
Review date: May 2017
Version number: 1
NST consultant leads: Dr N Sharer, Dr S Parry
We can supply this information in other formats, in larger print, on audiotape, or
have it translated for you. Please call the Patient Advice and Liaison Service
(PALS) on 01202 448499, text 07758 272495 or email [email protected] for advice.
If you wish to make any comments or to ask about any research evidence used to
write this leaflet, please contact the Patient Information Team confidentially: phone
01202 448003, write to the Health Information Centre (address above), or email
[email protected].
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