Intravenous nutrition
TAM (Treatments and Medicines) NHS Highland
- Order total parenteral nutrition (TPN) from Raigmore Hospital Pharmacy Department using the TPN prescriptions proforma provided.
- The standard TPN regimes are outlined in the table below.
- Information on prescribing TPN in Raigmore Hospital is available in the General Surgery Foundation Year Doctors’ Handbook or from Pharmacy Production staff, tel: 01463 704000 (switchboard).
|
Total parenteral nutrition regimes: |
Regimen 1 |
Regimen 2 |
Regimen 3 |
Regimen 4 |
Regimen 5 |
Regimen 6 |
|---|---|---|---|---|---|---|
|
TOTAL Nitrogen (g) |
5·7 |
11·4 |
10·2 |
13·6 |
15 |
20 |
|
TOTAL Glucose (g) |
80 |
160 |
225 |
300 |
270 |
360 |
|
TOTAL Lipid (g) |
50 |
75 |
75 |
100 |
75 |
100 |
|
TOTAL (Kcal) |
955 |
1910 |
1900 |
2530 |
2215 |
2950 |
|
TOTAL Volume (mL) |
1265 |
2515 |
1890 |
2515 |
1890 |
2655·5 |
|
Sodium (mmol) |
50 |
100 |
75 |
100 |
100·5 |
70 |
|
Potassium (mmol) |
30 |
60 |
52·5 |
70 |
70·5 |
60 |
|
Calcium (mmol) |
3 |
6 |
6 |
8 |
7·95 |
5 |
|
Magnesium (mmol) |
3 |
6 |
6 |
8 |
7·95 |
5 |
|
Phosphate (mmol) |
7·5 |
15 |
22·5 |
30 |
30 |
20 |
|
Cernevit (1vial) |
1 |
1 |
1 |
1 |
1 |
1 |
|
Additrace (10mL) |
1 |
1 |
1 |
1 |
1 |
1 |
|
Infusion rate mL/hour over 24 hours |
52 |
104 |
78 |
104 |
78 |
106 |
Out of hours supply
- Raigmore Hospital holds emergency stocks of NuTRIflex Lipid Peri 1250mL. This bag is highlighted in grey above, however bags taken from emergency stock will not contain Cernevit and Additrace
- If TPN is required outside Pharmacy opening hours, this is the only bag which may be used.
- The NuTRIflex 1250mL bag can be administered via both a central line and a peripheral cannula.
- The NuTRIflex Lipid 1250mL TPN bag should be prescribed on the fluid chart with the rate of administration added.
- The flow rate should be 26mL/hour for the first 48 hours for patients starting TPN or until the patient has been assessed by a Dietitian.
- Refer these patients to a Dietitian as soon as possible.