Total Parenteral Nutrition Liver Disease (TPN) | Medical Algorithm

Are you evaluating a patient who is receiving total parenteral nutrition?

Yes

Body weight of the patient

Lipid intake

grams per day

Has the patient been receiving TPN for months or years?

Yes

Does/Has/Is the patient?

• have the short bowel syndrome?

Yes

• had recurrent infections or sepsis since starting TPN?

Yes

• deficient in protein, carinitine, choline, lecithin or glutathione?

Yes

• have pre-existing or concurrent liver disease?

Yes

Does the infusate contain excess manganese or other trace metals?

Yes

Results

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Results Interpretation and Description References Next Steps

Data complete?

Evaluation appropriate?

Number of risk factors for liver disease

Is the person at risk for liver disease?

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Risk Factors
- Risk Factors for Gallbladder Disease Secondary to Parenteral Nutrition
Other Testing
- Fat Overload Syndrome
Severity, Prognosis, Stage
- Algorithm of Kaufman et al for Predicting Parenteral Nutrition-Associated Liver Disease (PNALD) in a Pediatric Patient with Short Bowel Syndrome of Infancy
Complications
- Lactic Acidosis Secondary to Thiamine Deficiency | Parenteral Nutrition

Monitoring

Disease Progression
- Lactic Acidosis Secondary to Thiamine Deficiency | Parenteral Nutrition

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Monitoring

Specialty

Objective

ICD-10

Risk Factors for Liver Disease Secondary to Parenteral Nutrition

Purpose: To identify risk factors for liver disease in a patient receiving total parenteral nutrition (TPN).

Evaluation

Results

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Interpretation and Description

References

Next Steps in Evaluation

Diagnosis

Monitoring

Specialty

Objective

ICD-10