Total Intravenous Nutrition

Abstract

Hypertonic glucose and nitrogen total intravenous nutrition (TIN) has become established treatment for certain critically ill patients. Complications with this technique have been significant and death has occurred. These complications are related to the need for prolonged maintenance of a central venous catheter and metabolism of large amounts of glucose. A soybean oil emulsion (Intralipid) has been used extensively in Europe and can provide calories through peripheral vein administration. This emulsion was given to 12 postoperative patients. There were no complications, and four of six patients studied developed positive nitrogen balance. In a similar group of four patients, glucose TIN produced weight gain and positive nitrogen balance in each case. The benefits of TIN are unchallenged, and positive nitrogen balance can be achieved in adults with either fat or glucose and a source of nitrogen.