Total parenteral nutrition

In this era of evidence-based medicine, total parenteral nutrition (TPN) therapy has been increasingly scrutinized. The effectiveness and safety of TPN, particularly in comparison to enteral feeding, and the clinical situations most appropriate for nutrition support have been discussed in many papers published recently. Innovative strategies such as supplementation of TPN with medium-chain triglycerides, glutamine or branched-chain amino acids have been compared with standard treatments. Increasing efforts have been made to avoid adverse effects associated with TPN, such as hyper glycemia, central venous catheter infection, and hepatic dysfunction. This review focuses on these issues as addressed by the recent literature.