My father has had a total small bowel and sub-total large bowel resection due to a carcinoid tumor. He is currently on a total TPN diet but continues to lose weight and is spending a lot of time in the hospital I feel he is not getting the proper amount of protein in his TPN. Any information on this subject would be greatly appreciated.
Lisa B. Aiello RN, MSN, OCN, Clinical Nurse Specialist for the University of Pennsylvania Health System Clinical Nutrition Support Services, responds:
Total Parenteral Nutrition (TPN) is a specialized therapy that not all physicians are trained and proficient in managing/ordering. It is a unique liquid diet combination given into the vein with a needle. The mixture contains all the protein, sugars, fat, vitamins, minerals, and other nutrients needed. There are many considerations to developing and managing a TPN prescription and TPN's associated complications, especially in the person with cancer. If you are concerned about your father's nutritional status, you should communicate this to the physician who is managing his TPN. If you are still not satisfied with his progress, I would recommend going to the closest teaching hospital and looking up their nutrition support service. There you should find a physician who specializes in TPN.