Total Parenteral Nutrition

Total parenteral nutrition (TPN) is a method of providing nutrition to a person intravenously, bypassing the digestive system entirely. It is typically used when a person is unable to receive adequate nutrition through the digestive system, either due to a medical condition or because of a surgical procedure. TPN is generally provided through a central line or port-a-cath. It is possible to administer TPN via the peripheral route with special catered formulas. The current market for PN peripheral are SmofKabiven® Peripheral 1206ml and 1904ml & Numeta G13E 300ml.

The maximum rate of TPN we can administered is calculated by 2ml/kg/hr, typically 12-16hours to run overnight depends on the volume and calories prescribed. Some individuals may experience nausea/vomitting or stomach upset which can be prevented by administering drugs like proton pump inhibitor or anti-nausea injection prior to start of TPN. Some individual may required extra fluid to run concurrently with TPN if there is electrolytes imbalance showing signs of dehydration.

Our care team will check your bloods once or twice weekly, customise and optimize the nutrition treatment for you. We are 24/7 accessible and a guide on infusion pump alarm and troubleshooting will be taught on the commencement date. We have administered over thousands cases of home TPN and >99% of our patients have no major issue and were satisfied with the care rendered. Be rest assured and contact us for more details. :)

Nutrition via Port-a-Cath

A Port-A-Cath is a small medical device that is surgically implanted beneath the skin of a patient. It is a type of central venous catheter, which is used to provide direct access to the patient’s veins for long-term drug therapy, chemotherapy, or other treatments. The device is accessed by an experienced nurse or doctor, who uses a special needle to connect to the port. This allows medications and fluids to be administered more quickly and efficiently, avoiding the risk of infection associated with traditional IVs. The port can remain in place for months or even years, and the patient can be monitored to ensure the port is functioning properly.

Generally, it is recommended to flush the device every 4-6weeks with 1:1000 concentrated heparin with positive pressure technique to ensure that it does not become clogged and able to use for the next administration or blood taking.

Vickycares have all the required consumables and all our team nurses are competent to access to port-a-cath under aseptic technique.

Nutrition via Central Venous Lines

Central venous access is a line inserted through a small incision made in the skin over the arm or chest under local anaesthesia, then the line is routed through the vein and into the heart. It can be secured in place with a non-stitched dressing aka statlock. Once the PICC line is in place, it can be used immediately to deliver nutrition.

We recommended 5-7 days of dressing change with chlorhexidine gluconate (CHG) impregnanted dressing to central venous line. Evidence studies have shown that it reduced the risk of catheter-related infection with CHG dressing instead of conventional adhesive film dressing (IV3000). A weekly flushing can be done together with the dressing change to keep the line patent

Vickycares have all the required consumables and our team nurses are competent to manage and provide caregiver teaching on dressing change and flushing. Consumables are available for purchase.