One is not the indication of total parenteral nutrition -
Parenteral nutrition involves the continuous infusion of a hyperosmolar solution containing carbohydrates, proteins, fat and other necessary nutrients through an indwelling catheter inserted into (usually) the superior vena cava.
Indications for Total parenteral Nutrition

The principal indications for parenteral nutrition are found in seriously ill patients when use of the gastrointestinal tract for feeding is not possible. In some instances intravenous nutrition may be used to supplement inadequate oral intake.

(A)As primary therapy
1.    Gastrointestinal cutaneous fistula including enteroenteric, enterocolic, enterovesical or enterocutaneous fistula.
2.    Renal failure (Acute tubular necrosis)
3.    Short bowel syndrome
4.    Severe burns
5.    Hepatic failure (acute decompensation superimposed on cirrhosis)
6.    Crohn's ds
7.    Anorexia nervosa
(B) As a supportive therapy

Acute radiation enteritis
Acute chemotherapy toxicity
Prolonged ileus
Weight loss preliminary to major surgery

(C) Areas under Intensive study

Patients with cancer
Patients with sepsis


About Pancreatitis  TPN was once a preferred route of providing nutritional support to patients with sever acute pancreatitis, but now jejunal enteral feeding is the preferred method with TPN required for few cases when


there is delay in providing jejunal enteral nutrition to patient with significant malnutrition for more than 3- 4 days
there is persistent ileus there is exacerbation of pancreatitis after enteral nutrition
Acute pancreatitis
Enterocolic fistula
Chronic liver disease
Faecal fistula