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Medical uses
Total parenteral nutrition (TPN) is provided when the gastrointestinal tract is nonfunctional because of an interruption in its continuity (it is blocked, or has a leak - a fistula) or because its absorptive capacity is impaired. It has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications. Parenteral nutrition is used to prevent malnutrition in patients who are unable to obtain adequate nutrients by oral or enteral routes. The Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition recommends waiting until hospital day number seven.

Absolute indications for TPN:


 * Short bowel syndrome
 * Small bowel obstruction
 * Active gastrointestinal bleeding
 * Pseudo-obstruction with complete intolerance to food
 * High-output (defined as > 500ml/day) enteric-cutaneous fistulas (unless a feeding tube can be passed distal to the fistula)

Gastrointestinal disorders
TPN may be the only feasible option for providing nutrition to patients who do not have a functioning gastrointestinal tract or who have disorders requiring complete bowel rest, including bowel obstruction, short bowel syndrome, gastroschisis, prolonged diarrhea regardless of its cause, very severe Crohn's disease or ulcerative colitis, and certain pediatric GI disorders including congenital GI anomalies and necrotizing enterocolitis.

Geriatric Population

In cancer
The benefit of TPN to cancer patients is largely debated, and studies to date have generally showed minimal long-term benefit.