PPN vs TPN: What’s the Difference Between TPN and PPN?

In medical terminology, PN stands for parenteral nutrition. This is when nutritional needs are delivered intravenously to patients who are unable to meet their dietary needs through regular digestion.

There are two primary types of PN, peripheral parenteral nutrition (PPN) and total parenteral nutrition (TPN). As the names imply, PPN is generally used for patients who need supplementary nutrition, while TPN is for patients who require all of their dietary needs replaced.

To better understand PPN versus TPN, it’s helpful to learn more about the specifics of parenteral nutrition and these two methods, as well as the situations where they are used. We’re providing the following guide to help you become more educated and engaged around this critical aspect of care.

Parenteral Nutrition and When PPN is Recommended Over TPN

There are many conditions and serious injuries that can disrupt the body’s ability to adequately absorb calories and essential nutrients through normal digestion. This can include certain types of cancer and cancer treatment, bowel obstructions, and short bowel syndrome. In these cases, serious malnourishment can be harmful to health or even life-threatening.

Any method of parenteral nutrition will involve inserting an IV line, and delivering nutrition through a specially developed formula that helps to deliver calories and nutrients. Both total and peripheral parenteral nutrition can be administered in a home or hospital setting, with home PN requiring specialized training and equipment.

The primary difference between PPN and TPN is usually in the ingredients of the formula and the duration of treatment. PPN will usually involve a more diluted formula with fewer calories and is only recommended for a short-term duration. In contrast, TPN is for long-term or even permanent duration, and will therefore use a denser, higher calorie formulation.

These differences usually involve different methods of administration.

Key features of PPN include:

• Administration through a peripheral catheter that requires a lower osmolarity
• Nutritional supplementation will have a lower calorie density due to the need for administration through smaller veins
• Requires nutritional needs from other sources, such as a feeding tube
• Commonly uses a three-in-one, total nutrient formulation with amino acids, dextrose, and intravenous lipid emulsion
• Can be transitioned into TPN if a longer duration is needed

Key features of TPN include:

• Usually administered through a central venous catheter, or CVC, such as a peripherally inserted central catheter (PICC) or a tunneled CVC
• An implanted port, also called port-a-cath or medi-ports, are the most permanent solution and can be used for long periods of time without replacement
• Higher calorie nutritional solution contains all necessary protein, carbohydrates, fats, minerals, electrolytes, and other trace nutrients normally obtained through food

Both TPN and PPN formulations will be carefully personalized to meet the specific needs of each patient.

Managing Potential Risks and Complications of PPN and TPN

If a doctor deems PPN or TPN necessary, there will be a procedure to insert the IV catheter. This will be performed with the patient under anesthesia and be connected to a vein that travels to the heart. TPN will usually be connected to a larger vein that can deliver more nutrients quickly and has a lower risk of catheter infection.

PPN usually requires catheter insertion into a smaller vein, which can raise the risk of infection.

Both TPN and PPN require careful monitoring of both the catheter site and the formulation to watch for signs of infection, nutritional imbalances, and other complications. Doctors will watch for proper liver function, protein levels, blood nitrogen levels, creatinine levels, urine sugar content, and other key indicators of receiving proper nutrition. Patients on both TPN and PPN undergo regular laboratory testing to ensure nutritional levels are within acceptable parameters.

Complications to watch for include:

• Catheter site infection
• Vascular injury and venous thrombosis
• Edema
• Bleeding
• Embolism, or air in the veins
• Liver dysfunction
• Malnourishment

Quality of life can be good for patients undergoing PPN or TPN, but an adjustment is usually required. In many cases, fatigue and reduced mobility are issues that many patients, including children, need to overcome.

For PPN or TPN administered at home, family members must be specially trained to ensure safe and healthy feeding. This can be a time-consuming and labor-intensive process that often requires assistance. A specially trained home health aide, including pediatric home health services, can help families provide a high level of care while balancing other needs at work and home.

Contact Sonas for Home Health Care in Florida

It can be hard to balance your time between work, home, and caring for a child. That’s why our team of skilled professionals at Sonas Home Health Care is here to help. We have been enforcing precautionary measures and following the Centers For Disease Control (CDC) guidelines for COVID-19 to ensure the safety and health of our clients and employees.

Our home health care services offer support in the comfort of your home. We refer loving and competent nurses to provide customized care for families — from a few hours a day to around-the-clock supervision. Contact us directly to speak with a home health care professional or request a free in-home assessment. Together we can determine the best plan of action to keep your loved ones happy and healthy.

If you or a loved one are considering Pediatric Home Health Care Services in Florida, contact the caring staff at Sonas Home Health Care. Call today at (888) 592-5855.

Jillian Miller BSN, RN

Director of Nursing at Sonas Home Health Care

This blog was reviewed by Jillian Miller BSN, RN — Director of Nursing for Sonas Home Health Care’s Tampa Bay market — for clinical accuracy. Jillian Miller has been a nurse for 16 years — working primarily in pediatrics. She believes the best part of working with the pediatric population is when you see smiles from clients when you first enter the room. She loves seeing the difference you can make in families’ lives while providing the best care possible for them.