Hi,
I've been reading some discussions here since my daughter started on TPN a little over a week ago.
I have a question about lipids..I've read that some have 2 bags to hang or a double chambered bag that gets mixed at use. My daughter just has one bag for 24 hrs. It does say in the ingredients that it contains "intralipid", is that the same thing? And why would hers not require separation? I just want to be sure the best thing is being done for my daughter, and we don't go back to the Dr til next week. She may be on TPN for only a short while, but since noone can figure out why she stopped tolerating her J feeds we can't really know how long she'll be on TPN. I dont' know if the length of time on tpn makes a difference in formulation etc, but am trying to educate myself as best I can so I can ask the right questions when we see the Dr next week.
THANKS
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lipids?
- By momto2girls
- Posted October 28, 2009 at 10:18 am · 5 replies
- In Home IV feeding (HPN, parenteral nutrition)
- Shared with the public
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- By charliegirl3
- Posted October 29, 2009 at 2:35 pm
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Hi mom,
I am on TPN the 24 hour bag. It has the same lipids in it that the two bag parts do . It is more convenient to handle one bag than two. If I may ask what happened that she couldn't tolerate her J tube feedings. I had a j tube and got terrible cramps and the runs. I felt so nauseated all the time. I have been on tpn for a month but probably be on it for along time since I can not tolerate solid foods. I hope someday soon I will be able to eat solids again. Good luck with everything. IS your daughter on 12 or 24 hour TPN. I am trying the 12 hour for the first time today. Last night my pump malfunctioned at 111 at night so I wanted to do it over the night but I am trying it today. Don't be afraid to ask any questions. No question is off limits. Hoped this helped. many happy days ahead. charliegirl3
- By momto2girls
- Posted October 29, 2009 at 7:10 pm
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Thanks Charliegirl3!
I figured it was fine but wondered why it would be put in 2 bags if it COULD be put in one.
My daughter is on 24 hr feeds. 4 yrs ago she was G tube fed, 3 boluses a day, plus an overnight feed sometimes. Then she started having huge issues, after year she was finally diagnosed with Gastroparesis--it took so long because we moved to a new state, and right afterward she started having GI issues when she had been stable for years, we didn't have any doctors, new GI docs were 2 hrs away and appts were 4 mos out! Anyhow, she ended up with a GJ at first, but that wouldn't stay in place more than a few days, so she ended up with a surgical J tube, about a year and a half ago, then a bowel obstruction, malrotation surgery with that repair and a lot of trauma to her whole GI system. After a short bout of TPN then to wait for a surgical ileus to resolve she was on 20 hr J feeds with no real issues, until about a month ago she started having some weird backwards motility, formula coming out her gtube, vomiting all sorts of weird GI stuff and that has landed us on TPN.
Much longer than you needed....sorry!
I hope your 12 hr bag works for you, that would be great to be off the pump for 12 hrs a day! I'm hoping that if she remains on TPN for any length of time we can shorten her feed as well, but don't think it will be possible right now, as it is I think they will have to increase something --rate and dose to add more fluids--since she's putting out so much drainage from her Gtube right now she's borderline dehydrated! We're trying pedialyte through her J tube but I think it's coming right out her G since we had even MORE drainage from it today since I added the pedialyte back in.
- By dogwalker
- Posted October 29, 2009 at 9:19 pm
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Hey momto2girls,
I believe 'intralipid' is formulated to be able to be given through a peripheral IV (doesn't need a central catheter). Hospitals routinely use the one bag tpn, however their formulations (at least in the adult population) can only be given through a central cath or a PICC line. Perhaps the one bag tpn that you have is simply the way that manufacturer makes the tpn containing the intralipids.
- By chrissybird
- Posted November 4, 2009 at 10:49 am
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The "3 in One" bags are much better than the two bag... believe me. The formulation (recipe) of the TPN determines whether or not you can do it. Some components can make the lipids separate over time when they are mixed all together. When we would have to use the two bag at home, if one pump wasn't alarming during the night another was... not fun. I'm guessing it was related to pressure issues. With the three in one you only have one pump to contend with and one set of tubing. Ollie at this point is on a nightly 9 hour rate and it has worked out quite well. We're actually in the hospital now (long story) but are hoping to get out at the end of the week. So my vote is that one bag is a great thing!
- By momto2girls
- Posted November 4, 2009 at 1:12 pm
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Thanks for the replies! I agree, less is more sometimes...as it is she has two pump and 3 bags attached even with just the one TPN pump (gtube to drain, and j tube feeding pedialyte at a whopping 10 ml/hr).
I hope you manage to get out of the hospital soon!
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