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Hi, it’s Patrik Hutzel from intensivecarehotline.com with another quick tip for families in intensive care.

Today, I want to talk about when is TPN indicated for a patient in ICU. So, whenever enteral feeds or oral feeds cannot be established, that means whenever someone can’t have nasogastric tube feeds, PEG (Percutaneous Endoscopic Gastrostomy) feeds, or can’t have oral feeds, that’s when TPN is indicated.

What is TPN? TPN stands for Total Parenteral Nutrition, and it is basically intravenous nutrition, which requires a central line, a PICC line, Hickman’s line, or a port catheter to administer the TPN.

Now, for patients in ICU, it’s not often the case, but it is certainly the case on and off. I have worked in critical care nursing for 25 years in three 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 as part of our consulting and advocacy. You can verify that in our testimonial section at intensivecarehotline.com or in the podcast section, where we’ve done some client interviews.

Currently, we are working with a client that needs TPN in ICU. He can’t have any nasogastric tube feeds, he can’t have any PEG tube feeds, he cannot have anything orally because he’s BIPAP (Bi-level Positive Airway Pressure)-dependent on high oxygen levels with high IPAP (Inspiratory Positive Airway Pressure) and EPAP (Expiratory Positive Airway Pressure), and he’s unable to have any enteral feeds because of that or oral intake. So, that means he needs TPN.

Now, the ICU team is very difficult in this situation because they are saying, “Well, we should not give TPN because there’s a risk of infection.” Well, from my perspective, that’s like saying, “Well, we shouldn’t be eating and drinking because food or drinks might be contaminated.” Is there a risk of infection? Of course, there is. But there’s a much higher risk of not feeding someone in the ICU. because the research is clearly saying that ICU patients need to have nutrition from Day 1 to manage critical illnesses more effectively.

There’s enough of research out there, so by not giving TPN or by withholding nutrition, that is actually medical negligence, as far as I’m concerned and it’s weakening an already weak patient, and it’s just highly inappropriate.

So, the bottom line is, you as a family in intensive care, you need to do your own research, and you need to get a second opinion so that no one takes advantage of you because ICU teams often have their own agenda, and that is often to get patients out of ICU as quickly as possible, which could include not giving nutrition, which could potentially kill a patient.

Also, keep in mind to always bring it back to common sense. Nutrition is a basic human right, so to say that we shouldn’t be giving TPN because there is an infection risk, like I said, once again, that’s like saying we should stop eating and drinking because the food might be contaminated, but there’s a small risk for that. And in the ICU, from my extensive experience, a line infection is a small possibility but if it’s managed correctly with the right skills and with the right experience, there’s actually no problem.

For example, some of you might know we are providing a service called Intensive Care at Home, you can find more information about at intensivecareathome.com.  At Intensive Care at Home, we are also providing home TPN, that means some of our clients are at home on TPN, and we are therefore sending our critical care nurses into the home to manage TPN, central lines, PICC lines, Hickman’s lines, and port catheters, no problem. The lines don’t get infected because it’s the skill we bring into the home that prevents that from happening in the first place.

Over the years, we have helped hundreds of clients and members here at intensivecarehotline.com, families in intensive care. Like I said, we have saved many lives, that’s why we’ve created a membership for families of critically ill patients in intensive care, and you can become a member if you go to intensivecarehotline.com and click on the membership link or if you go to intensivecaresupport.org directly. In the membership, you will have access to me and my team, 24 hours a day, in a membership area and via email, and we answer all intensive care related questions.

In the membership, you also have exclusive access to 21 e-books and 21 videos that I’ve personally written and recorded, sharing all of my 25 years of intensive care nursing experience and advocacy with our members, making sure you make informed decisions, you have peace of mind, control, power, and influence, making sure your loved one gets the best care and treatment always.

I also do one-on-one consulting and advocacy over the phone, Zoom, Skype, or WhatsApp, whichever medium works best for you. I talk to you and your family directly. I also speak to doctors and nurses directly. When I talk to the doctors directly, I ask all the questions that you haven’t even considered asking, but must be asked when you have a loved one critically ill in intensive care. When I do one-on-one consulting with you and your family, I handhold you through this once-in-a-lifetime situation that you simply can’t afford to get wrong. I also represent you in family meetings with intensive care teams.

We also do medical record reviews in real-time so 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 at the top of our website, or simply send 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, and comment below  what you want to see next or what questions and insights you have from this video, share the video with your friends and families.

I also do a weekly YouTube live where I answer your questions live on the show. You will get a notification for the YouTube live if you’re a subscriber to my email newsletter at intensivecarehotline.com or if you are a subscriber to my YouTube channel.

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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