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Surgery General 82f6ec56

One is not the indication of total parenteral nutrition -

A
Acute pancreatitis
B
Enterocolic fistula
C
Chronic liver disease
D
Faecal fistula
High-Yield Explanation
Parenteral nutrition involves the continuous infusion of a hyperosmolar solution containing carbohydrates, proteins, fat and other necessary nutrients through an indwelling catheter inserted into (usually) the superior vena cava. Indications for Total parenteral Nutrition The principal indications for parenteral nutrition are found in seriously ill patients when use of the gastrointestinal tract for feeding is not possible. In some instances intravenous nutrition may be used to supplement inadequate oral intake. (A)As primary therapy 1.    Gastrointestinal cutaneous fistula including enteroenteric, enterocolic, enterovesical or enterocutaneous fistula. 2.    Renal failure (Acute tubular necrosis) 3.    Short bowel syndrome 4.    Severe burns 5.    Hepatic failure (acute decompensation superimposed on cirrhosis) 6.    Crohn's ds 7.    Anorexia nervosa (B) As a supportive therapy Acute radiation enteritis Acute chemotherapy toxicity Prolonged ileus Weight loss preliminary to major surgery (C) Areas under Intensive study Patients with cancer Patients with sepsis About Pancreatitis  TPN was once a preferred route of providing nutritional support to patients with sever acute pancreatitis, but now jejunal enteral feeding is the preferred method with TPN required for few cases when there is delay in providing jejunal enteral nutrition to patient with significant malnutrition for more than 3- 4 days there is persistent ileus there is exacerbation of pancreatitis after enteral nutrition

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