TOTAL PARENTERAL-NUTRITION

Total parenteral nutrition (TPN) is an important treatment option in t he nutritional support of patients with short bowel syndrome or mandat ed bowel rest, Although enteral access should preferably be obtained a t the earliest opportunity, TPN remains a beneficial therapy for those patients who cannot tolerate enteral feeding. Although protein requir ements have now generally been determined, caloric requirements in TPN remain controversial. Avoidance of overfeeding is important owing to associated complications such as hyperglycemia, hepatic steatosis, and , probably, increased risk of infection. Novel substrates currently un der investigation may improve our ability to modulate the inflammatory response in patients who require TPN. This review concentrates on rec ent literature that pertains to advances in the field of TPN.