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I have experience in dealing with situations like what you describe. I work in acute care (the hospital). Initially, patients are "fed" through IV with either PPN (partial parenteral nutrition)which is given through a peripheral IV site or TPN(total parenteral nutrition) which usually requires a central line. IV feedings are risky, and they require close monitoring of bloodwork and weight, intake and output. There is risk of infection as the TPN is a great place for bacteria to live in and gain direct access to the bloodstream. Also there is a risk of extravasation, in which the PPN doesn't stay in the vein but is injected in the tissue which causes severe damage to the body part. TPN and PPN require a daily order written by the patient's doctor. This is why IV nutrition is only done in the hospital as it requires the close monitoring of doctors and nurses. IV nutrition is only done on people who have a non-functioning gastrointestinal tract and for a short period of time such as a few weeks. For example, patients with bowel obstructions, patients undergoing abdominal surgery like a colectomy or colostomy, etc. would qualify. IV nutrition is also done for patients who are awaiting placement of a feeding tube. Feeding tubes are used for term nutritional support. They are inserted in a minor OR under conscious sedation. tubes are placed in patients who need term nutritional support and can be maintained in a nursing home or even at home. Unliscensed people can administer tube feeding if they are trained. Feeding tubes also have risks such as aspiration, where they can choke on their tube feeding and develop pneumonia if positioned with their head at less than a 45 degree. patients on tube feeding suffer from constant diarrhea and subsequent bed sores if their body cannot adjust to the feeding. Whether or not a patient gets a feeding tube is a decision made by both the family and the patient's doctors, and if the person had a living -/advanced directives that is taken into consideration. It's a difficult choice to make and there's no easy way about it. That's why the decision is individualized. I that helped you and I'm sorry your family is going through this. Kansas web chat
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