A review of total parenteral nutrition.

New techniques widen the anesthetist's scope and understanding, while placing a new perspective on total anesthesia care and management. Here is one such technique that bears consideration. Total parenteral nutrition (TPN) is the continuous intravenous injection of hypertonic solutions of dextrose, protein (as crystalline amino acid or hydrosalate), vitamins and trace elements. It maintains the status quo in patients unable to utilize nutrients by achieving a positive nitrogen balance, weight gain and normal wound healing. It is used in treatment or prevention of malnutrition from varying causes: surgical, pathological and psychological. These include: 1. Preoperative preparation of the malnourished patient. 2. Prolonged postoperative surgical complications (such as, postbowel resection). 3. Inflammatory bowel disease (such as, ulcerative colitis). 4. Inadequate oral intake. 5. Hypercatabolic states (such as, burns and fever). 6. Psychiatric problems (such as, anorexia nervosa). Total parenteral nutrition is prescribed by the physician in relation to each particular patient's needs.