TPN may be complicated by -
• Characterized by severe fluid and electrolyte shifts in malnourished patients undergoing refeeding.
• It can occur with either enteral or parenteral nutrition but is more common with the latter.
• It results in hypophosphataemia, hypocalcaemia and hypomagnesaemia.
• Risk Factors: Alcohol dependency, severe malnutrition, Anorexics and prolonged periods of fasting.
Treatment
• Treatment involves matching intakes with requirements and assiduously avoiding overfeeding.
• Calorie delivery should be increased slowly and vitamins administered regularly.
• Hypophosphataemia and hypomagnesaemia require treatment.
Obstructive jaundice
Hyperosteosis
Hypercalcemia
Pancreatitis