Parenteral nutrition in surgical patient

We describe our experience about Total Parenteral Nutrition (TPN) in surgical patients matured in the Surgical Clinic of Genoa University from 1975 to 1988. In this paper we describe the method we have used to plan the TPN: computing caloric requirements, caloric/nitrogen ratio, salts-water balance, using or not lipid emulsions and in what proportion. We explain also how we check the TPN in first, second, third day and later. In these years 533 patients had undergone to this nutritional procedure in pre- and postoperative period. Our patients were affected by gastrointestinal pathology in 90 percent of cases. A large number of these was affected by malignant tumors (over 48%) or by hepatic failure (12-19%). In some cases TPN was the major therapy used. A little reduction in number of TPN done during the last year is due to increased number of partial parenteral nutrition, enteral alimentation with chemical definited diets. The use of TPN was able to reduce morbidity and morbidity of major surgical procedures with low rate of complications (1.1% of major metabolic complications and 2.9% of complications related to venous catheterism).