Previous section | Next section

Complications

Metabolic complications should be detected by appropriate monitoring. Some of the more common complications are as follows.

Fluid overload

This may occur when other blood products and fluids are given concurrently. It may be possible to reduce the volume of a bag of parenteral nutrition while maintaining the nutritional content. A pharmacist and dietician can advise on the feasibility of creating such regimens.

Impaired liver function

Long‐term parenteral nutrition and the lack of enteral nutrition may contribute to altered liver function and cholestasis. Liver function may be influenced by the total amount of glucose that is administered, the quantity and composition of lipid in parenteral nutrition, the type of administration (e.g. over 24 hours), and any underlying hepatic pathology (Das and Bowling [43]).

Hyperglycaemia

This may occur due to stress‐induced insulin resistance or carbohydrate overload. A simultaneous sliding scale insulin infusion may be required. Failure to recognize hyperglycaemia may result in osmotic diuresis.

Hypoglycaemia

Abrupt cessation of parenteral nutrition may result in rebound hypoglycaemia. A reduction in infusion to half the rate prior to stopping the infusion may help to prevent this occurring.
Previous section | Next section