Intradialytic Parenteral Nutrition (IDPN) is a supplemental form of parenteral nutrition prescribed to provide malnourished hemodialysis patients with the protein, calories and other nutrients that their body needs for strength and energy. IDPN (Intradialytic Parenteral Nutrition) is a solution of amino acids, dextrose and, if needed, lipids administered through the dialysis machine directly into the bloodstream while a patient is receiving dialysis. Each formula is custom tailored to the patient’s specific needs.
Nutritionally deficient dialysis patients may be given IDPN as a form of protein repletion when traditional means of replenishment are unsuccessful. IDPN helps patients who are unable to meet their nutritional needs through oral diet and traditional means of protein replenishment, such as intensive nutritional counseling and oral supplementation. IDPN can effectively help to restore nutritional status to a level at which oral or enteral feeding might again be successful. Intradialytic parenteral nutrition should be given until the patient’s nutritional status is improved, at which time oral nutritional supplementation will then be sufficient for maintenance.
Intradialytic parenteral nutrition (IDPN) is administered through an infusion pump that can overcome venous pressure in the dialysis blood lines. The fluid is then mixed with the patient’s venous blood and returned to the body through the venous access. Because IDPN is administered during dialysis, convenience is probably its most important advantage. Additional vascular access is not required, and IDPN administration obviates the need for prolonged dialysis or additional trips to the clinic.
Electrolyte imbalance and fluid overload are common concerns when patients are administered parenteral nutrition. With IDPN, the content of the solution can be adjusted with relative ease according to the patient’s clinical or metabolic requirements.
Total Parenteral Nutrition (TPN) is a complete form of parenteral nutrition used for patients who cannot or should not get their nutrition through eating. Total Parenteral Nutrition solutions contain nutrients the body would normally get from food, such as protein, carbohydrates, fats, vitamins, minerals, and water. TPN is only used if other methods to feed into the gastrointestinal tract have failed or are not possible.
Normal digestion occurs when food is broken down in the stomach and bowel, then absorbed. These absorbed products are carried by the blood to all parts of the body. Certain diseases, surgeries, and injuries can cause problems with the normal process of digestion and absorption which occurs within the gastrointestinal tract. The stomach or bowel may not be working normally or a person may have had surgery to remove part or all of these organs. Because TPN is given intravenously, it bypasses the gastrointestinal tract.
TPN solutions are tailored to the needs of each patient. The content of a TPN solution is determined based on the age, weight, height, and the medical condition of the individual. Solutions contain amino acids and dextrose, lipids are optional. Electrolytes such as potassium, sodium, calcium, magnesium, chloride, and phosphate are also included, as these are essential to the normal functioning of the body. Trace elements such as zinc, copper, manganese and chromium are used.
Normally TPN is administered in a hospital, but under certain conditions and with proper patient and caregiver education, it may also be used at home for long-term therapy. TPN use may be temporary or lifelong. Many times, parenteral nutrition is used for a short time, then it is removed when the person can begin to eat normally again. With time and experience, people using TPN can have improved quality of life.
Antibiotics are a class of drug designed to work against bacteria. They can either actively kill bacteria to stop an infection or they can interfere with bacterial reproduction, making it difficult for an infection to spread. As generations of the organisms die, the infection is gradually brought under control. Some drugs are broad spectrum and will work against many different organisms, while others target particular bacteria and are not suitable for generic use.
Intravenous antibiotics are antibiotic medications designed to be delivered directly into the bloodstream. They are an alternative to oral antibiotics taken by mouth and topical antibiotics applied directly to the site where an infection is located. An advantage of intravenous antibiotic therapy over oral administration is the ability to bypass the gastrointestinal tract. Drugs taken by mouth must be absorbed through the gut before they can start attacking an infection. Delivering antibiotics intravenously means that the drugs act quickly, which can be critical in an emergency situation. When drugs are introduced directly into the bloodstream, they will travel rapidly to the site of an infection and immediately begin working. For people with severe infections, intravenous antibiotics may be used because they will take effect quickly.
Immune globulin is a sterilized solution obtained from pooled human blood plasma, which contains immunoglobulins (or antibodies) to protect against the infectious agents that cause various diseases. People who are exposed to or in danger of being exposed to certain infectious diseases may benefit from the use of intravenous immunoglobulin (IVIG) therapy.
Antibodies are substances in the blood plasma that fight infections. Our bodies create antibodies (or immunity) against disease-causing agents when infections occur. These antibodies can protect us from becoming ill if we are exposed to the same infectious agents sometime in the future. When someone is given immunoglobulin, that person is using other people’s antibodies to help fight off or prevent an illness from occurring. Appropriately treating primary immunodeficiency with IVIG preserves organ function, improves quality of life, prevents infection-related death, and increases lifespan.
Primary immunodeficiency is caused by inherent defects of the immune system and results in recurrent, severe or unusual infections. The clinical use of intravenous immunoglobulin (IVIG) has expanded beyond its traditional place in the treatment of patients with primary immunodeficiency. Due to its multiple anti-inflammatory and immunomodulatory properties, IVIG is used successfully in a wide range of autoimmune and inflammatory conditions. The long-term goal of IVIG therapy is to render the patient infection free, to the greatest extent possible.