How to Design Total Parenteral Nutrition

Designing Total Parenteral Nutrition (TPN), can you do this?

How do you order TPN? When is total parenteral nutrition indicated?

Why does TPN seem so complicated and why have I avoided it all this time?

Rest easy, in this video your questions will be answered and your fears relieved!

MUST HAVE SURGERY BOOKS

Over the last few videos we've been building up to this talk with the last two discussions on surgical nutrition and now you're ready to learn about TPN. Today's goal is to understand when TPN is indicated and how you can write and order it! If you haven't had a chance to check out the first two videos definitely check them out here:

Surgical Nutrition and TPN is a foundational talk in surgery and you should definitely have a firm grasp on surgical nutrition as an intern and definitely definitely before your board exams! For the medical students out there definitely check these videos out and you'll be ahead of your peers with respect to assessing the nutritional status and delivering nutrition when indicated.

YOU WILL LEARN THE FOLLOWING
1.) Understand the Indications for TPN
2.). Understand the difference between TPN and PPN
3.). Understand how to write a basic TPN order

FAST FORWARD WITH THESE INCREDIBLE TIMESTAMPS

Start 00:00
Goals for the Discussion 03:19
Why is Learning TPN so Important 03:52
Key References 04:31
ESPEN Recommendations 05:39
Indications for TPN 07:11
Peripheral Parenteral Nutrition or Total Parenteral Nutrition? 08:10
Calculating Carbohydrates in TPN 10:17
Calculating Lipids in TPN 11:14
Calculating Protein in TPN 12:56
Sample Calculation for Writing TPN 14:14
How about electrolytes? 17:52
Specific nutrients added to TPN 18:31
Why individualized TPN solutions 19:58
Nutrients and Specific Deficiencies (SCREENSHOT THIS) 21:30
Two in One or Three in One TPN Solutions? 22:19
Is Weaning TPN Necessary? 23:07
Summarizing TPN and Putting it All Together 23:32

REFERENCES

BE MY FRIEND

WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!

DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. Good luck and enjoy!

Affiliate Links - There are a few links in the description that may lead to a kickback to me to help support the channel.

[SJ-hdbr]

Again, thank you so much! You really simplified the information in 30 pages of textbook on this topic.

[ChloeDunIT]

Thank you for producing this video, you explain things so much better than the text books!

[Katy_Sato]

Great learning session there sir.
Dietitian from Kenya.

[MMm-giwk]

Thanks so much for a great tutorial! I have only discovered your series this afternoon and have already learnt so much!
Would you consider a future learning session on albumin and the role of its measurement and when to supplement post-operatively please?
Thanks again! :-)

[dr.alishmehta]

Just completed the lecture. It was wonderful. Sir, can we've a lecture on surgical audit.

Best wishes from India.

[emmym.]

Not a doctor but I’ve been on TPN for 6 years now and just curious about how it works. Good video! Also if anyone watching this has any questions for a long term TPN patient I’d be happy to answer

[maenal-khashashneh]

Thanks, nice work
But I think if 1gm of lipid equal 9kcal and with intralipid 10% the volume should be 700 ml .
Please could you explain it if l'm wrong

[shylajadeenadayalan]

How is protein calculated ? Can u explain ?

[kangumejustusamooti]

Do you have a PDFs for self assessment

[layanmohsen]

in 17:07, why are the dextrose grams divided by 2440 instead of 633 ml ?

[andresraulmalpartida]

If omega -6 suppresses immunity wouldn’t it be anti inflammatory instead of pro inflammatory ?

[mrgfdrttr]

Maybe my math is off, please correct me if so but towards the end isn't 110 ml/hr x 24 hrs ~ 2640 ml ?

[dramitnehra]

But Sir this patient is ICU, I mean the patient should be consider for more than 30 kcal/ kg Sir ????