Sunday, March 15, 2009

TPN Study Results (Greece)/ PICC Study Results (U.S.)

I found a short blurb about the use of TPN (Total Parenteral Nutrition) for HG:

"Traditionally, total parenteral nutrition has been used when patients with
hyperemesis gravidarum fail to respond to conservative measures, including
dietary manipulation and antiemetics. Total parenteral nutrition has been shown
to be an effective method of nutritional support during pregnancy but it
is expensive and has potentially serious complications.
Peripheral parenteral nutrition reduces the risk of complications, but caloric intake is limited. A small number of investigators have suggested using enteral nutrition as an alternative to total parenteral nutrition," wrote D.K. Christodoulou and colleagues, University of Ioannina.

I did have TPN for about a week before I developed blood clots in the area of the PICC Line used for the TPN. It is very specific nutrition, vitamins are added to each new bag. It was very expensive at a price tag of $1500 per bag (That did not include other costs : home delivery and home nurse, and all the other drugs that are required to keep the line clean: heparin and saline syringes etc.) After I developed blood clots the PICC Line had to be removed which was a complication in itself because now I was back to square one AND I had life threatening blood clots! Which is where this little blurb from another study comes in:

"More than one half of patients who received a PICC experienced a serious
or potentially life-threatening complication directly related to the treatment. Because there were no differences in neonatal outcomes, the authors conclude that PICCs should be avoided in the treatment of hyperemesis gravidarum..."

Amy Crawford-Faucher. (2008). Effectiveness of Treatment Options for Hyperemesis Gravidarum. American Family Physician, 78(9), 1089-1090. Retrieved March 15, 2009, from
Research Library Core database. (Document ID: 1584143891).

The study showed that the complications associated with PICC Line use to be: Thrombosis (blood clots), Pulmonary Embolus (blood clot in lungs or a clot that traveled to the lungs), Localized Cellulitis (inflammation of subcutaneous tissue), and Sepsis (pathogens or toxins in the bloodstream or tissues).

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