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If you want to know if TPN (Total Parenteral Nutrition) should be given, if your family member is in intensive care on a ventilator with a breathing tube and a bowel obstruction, stay tuned. I’ve got news for you.
Today, I have an email from Anika who says, “Hi Patrik, my mother is in intensive care on a ventilator with a breathing tube for a bowel obstruction and no nasogastric tube feeds have been given so far. Should she have TPN instead?” Well, the short answer is yes.
By the way, my name is Patrik Hutzel from intensivecarehotline.com and this is another quick tip for families in intensive care.
So, when someone is in intensive care with a bowel obstruction and they’re operating on that bowel obstruction or even if it’s managed conservatively, most of the time nasogastric tube feeds are not an option, or if someone has a PEG (Percutaneous Endoscopic Gastrostomy) tube, PEG tube feeds are not an option for a bowel obstruction.
So, in a nutshell, yes, TPN should be given because critically ill patients need nutrition. There’s enough research out there that suggests that early feeding for critically ill patients is beneficial for critically ill patients, and therefore, survival rates go up and mortality rates go down.
If the bowel obstruction is only for a couple of days, and maybe there’s an ending sight from when nasogastric tube feeds or PEG tube feeds can be given, then maybe TPN is not the right step, but they’re not right next step. But whenever there’s a prolonged withholding of nasogastric tube, oral, or PEG tube feeds in intensive care, then TPN (Total Parenteral Nutrition) should absolutely be considered.
Some voices might come here and might say, “Oh well, there’s a risk of infection for TPN or if TPN is given.” There is a small risk for infection when someone is having TPN via central line, PICC line, Hickman’s line, port-a-cath, there is a small risk for that, but that’s also why we’ve got intensive care doctors and intensive care nurses managing that risk. That’s why people are highly skilled and why people are highly trained to avoid those line infections. TPN has to be connected, sterile, and also has to be disconnected, sterile, and the lines have to be flushed with normal saline or even with heparinized saline.
So, not giving TPN when with a bowel obstruction or other conditions where someone can’t have oral, nasogastric tube, or PEG tube feeds is like saying, we stop eating because food might be contaminated. Yes, there is a small risk that food might be contaminated, but it is very unlikely in this day and age.
So, this decision from my experience is very straightforward. Also, nutrition is a basic human right. So, for someone to say, “Oh, well, you can’t have TPN”, whilst withholding PEG tube feed, nasogastric tube feeds, oral feeds is basically denying a basic human right, and people could die because of it, and that, in my mind, would be a criminal act.
So, I have worked in critical care nursing for 25 years in 3 different countries, where I worked as a nurse manager for over 5 years, and I’ve been consulting and advocating for families in intensive care since 2013 here at intensivecarehotline.com. I can very confidently say that we have saved many lives for our clients in intensive care. You can verify that on our testimonial section at intensivecarehotline.com or you can verify it on our intensivecarehotline.com podcast section where we’ve done client interviews.
I know that our advice here is absolutely life changing. Again, you can verify that on our testimonial section and on our podcast section. You can join a growing number of clients and members that we have helped over these, hundreds and hundreds of them, all over the world by reviewing medical records, by talking to doctors and nurses directly, by asking all the hard questions, and by holding doctors and nurses accountable, by writing complaints letters to hospitals and always been successful with that, by having been in many family meetings with our clients with intensive care teams advocating for them in family meetings. So, we are here to achieve results, and you can join us as well, getting results with our help.
That’s why I do one-on-one consulting and advocacy over the phone, Zoom, Skype, WhatsApp, whichever medium works best for you. I talk to you and your families directly. I handhold you through this once in a lifetime situation that you cannot afford to get wrong. I also talk to doctors and nurses directly. When I talk to doctors and nurses directly on your behalf or with you on a three-way call, I ask all the questions that you have not even considered asking but must be asked when you have a loved one critically ill in intensive care. I also represent you in family meetings with intensive care teams.
We also do medical record reviews in real time, so that you can get a second opinion in real time. We also do medical record reviews after intensive care if you have unanswered questions, if you need closure, or if you are suspecting medical negligence.
All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.
We also have a membership for families of critically ill patients in intensive care. You can become a member if you go to intensivecarehotline.com, if you click on the membership link, or if you go to intensivecaresupport.org directly. In the membership, you have access to me and my team, 24 hours a day, in the membership area and via email, and we answer all questions intensive care related. In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded. That would help you to make informed decisions, have peace of mind, control, power, influence, so that your loved one gets best care and treatment always and you make informed decisions, have peace of mind, control, power, and influence.
All of that, you get at intensivecarehotline.com. Call us on one of the numbers on the top of our website or simply send us an email to [email protected] with your questions.
If you like my videos, subscribe to my YouTube channel for regular updates for families in intensive care, click the like button, click the notification bell, share this video with your friends and families, comment below what you want to see next, what questions and insights you have from this video.
I also do a weekly YouTube Live where I answer your questions live on a show. You will get notification for the YouTube live if you are a subscriber to my YouTube channel, or if you are a subscriber to my intensivecarehotline.com email newsletter at intensivecarehotline.com.
Thank you so much for watching.
This is Patrik Hutzel from intensivecarehotline.com and I will talk to you in a few days.
Take care for now.
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