Partial parenteral nutrition (just amount of nutrients by the vein, usually by the arm)
■ Complement enteral nutrition
■ 5-15 days (time you can use a peripheral access)
■ <900 mOsm/L
■ Peripheral veins ( if it exceeds 15 days need a central line)
● Examples (those that will respond in 2 weeks): active chron, CUCI, celiac, (because you expect inflammation to go down in 2 weeks) Chemo
Total parenteral nutrition
■ Total nutrition (2000 mOsm/l): macronutrients, micronutrients, trace elements, AA, electrolytes, H2O glutamines, carnitina, W3
■ Except: fiber, probiotics, proteins (you give AA instead)
■ Central access (superior cava vein)
■ Examples (if you don’t have a gut, necrosis, if it is not moving, loosing a lotfistula, diarrea, vomit) : necrotic pancreatitis, jejunal high output fistula (500 gr) (if you feed them through the gut they lose more water and electrolytes) , severe paralytic ileus, short bowel syndrome , uncoercive vomit/diarrhea, frozen abdomen/septic abdomen
● In short bowel you need both enteral and parenteral (you use the gut with minimal enteral nutrition for throphism to stimulate intestinalización of the colon to be able to behave as a enterocyte which takes 2 years but you give parenteral nutrition to actually feed them
