Hanyang Med Rev.  2011 Nov;31(4):269-275. 10.7599/hmr.2011.31.4.269.

Management and Prevention of Possible Complications Associated with Total Parenteral Nutrition

  • 1Department of Pediatrics, Hanyang University College of Medicine, Seoul, Korea. kyjoo@hanyang.ac.kr


Nutritional therapy with total parenteral nutrition (TPN) is usually performed in the critically ill patients who cannot ingest or digest food through the gastrointestinal tract. The process of well managed nutritional support by TPN is not simple, nor easy. Doctors experience various complications, the patients also suffer from much discomfort. Especially the younger patients, they are labile to more complications. The physicians should know thoroughly how to avoid the complications, how to effectively supply TPN solution to the patients. The author reviews the numerous complications during TPN and the methods for the prevention of complications.


Parenteral Nutrition, Total; Nutritional and Metabolic Diseases; Complications of Parenteral Nutrition

MeSH Terms

Critical Illness
Gastrointestinal Tract
Nutritional and Metabolic Diseases
Nutritional Support
Parenteral Nutrition, Total


1. Collier SB, Richardson DS, Pharm DKMG, Duggan C. Hendricks KM, Duggan C, Walker WA, editors. Parenteral nutrition. Manual of pediatric nutrition. 2000. Hamilton: B.C. Decker;242–287.
2. Weinsier RL, Krumdieck CL. Death resulting from overzealous total parenteral nutrition: the refeeding syndrome revisited. Am J Clin Nutr. 1981. 34:393–399.
3. Peden VH, Witzleben CL, Skelton MA. Total parenteral nutrition. J Pediatr. 1971. 78:180–181.
4. Vileisis RA, Inwood RJ, Hunt CE. Laboratory monitoring of parenteral nutrition-associated hepatic dysfunction in infants. Journal of Parenteral and Enteral Nutrition. 1981. 5:67–69.
5. Kerner JA. Kerner JA, editor. Metabolic complication. Manual of pediatric parenteral nutrition. 1983. New York: John Wiley & Sons;199–215.
6. Kien CL, Chusid MJ. Eosinophilia in children receiving parenteral nutrition support. JPEN J Parenter Enteral Nutr. 1979. 3:468–469.
7. Mitchell SM, Rogers SP, Hicks PD, Hawthorne KM, Parker BR, Abrams SA. High frequencies of elevated alkaline phosphatase activity and rickets exist in extremely low birth weight infants despite current nutritional support. BMC Pediatr. 2009. 9:47.
8. Leape LL, Valaes T. Rickets in low birth weight infants receiving total parenteral nutrition. J Pediatr Surg. 1976. 11:665–674.
9. Kimura S, Nose O, Harada T, Maki I, Kanaya S, Tajiri H, et al. Serum Levels of Vitamin D Metabolites in Children Receiving Total Parenteral Nutrition. Journal of Parenteral and Enteral Nutrition. 1986. 10:191–194.
10. Kamen BA, Gunther N, Sowinsky N, Rizzo J, Marsik F. Analysis of antibiotic stability in a parenteral nutrition solution. Pediatr Infect Dis. 1985. 4:387–389.
11. Macias JM, Martin WJ, Lloyd CW. Stability of morphine sulfate and meperidine hydrochloride in a parenteral nutrient formulation. Am J Hosp Pharm. 1985. 42:1087–1094.
12. Athanikar N, Boyer B, Deamer R, Harbison H, Henry RS, Jurgens R Jr, et al. Visual compatibility of 30 additives with a parenteral nutrient solution. Am J Hosp Pharm. 1979. 36:511–513.
13. Zaccardelli DS, Krcmarik CS, Wolk R, Khalidi N. Stability of imipenem and cilastatin sodium in total parenteral nutrient solution. JPEN J Parenter Enteral Nutr. 1990. 14:306–309.
14. Niemiec PW Jr, Vanderveen TW. Compatibility considerations in parenteral nutrient solutions. Am J Hosp Pharm. 1984. 41:893–911.
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