Safety of Discontinuing TPN for Hospital Transfer

Patient Assessment and Preparation

TPN should only be discontinued in patients whose fluid and electrolyte requirements have stabilized, as recommended by the American Gastroenterological Association 1, 2
Patients should be hemodynamically stable with no signs of metabolic disturbances, according to the American Gastroenterological Association 2, 3
Blood glucose levels should be monitored before and after discontinuation to ensure normoglycemia, as suggested by the Clinical Nutrition society 4

Young infants (<2 years) may require special consideration when discontinuing TPN for transfer due to immature gluconeogenesis and limited glycogen stores, as noted by the Clinical Nutrition society 4
Patients with brittle diabetes or other metabolic disorders may require special consideration when discontinuing TPN for transfer, according to the American Gastroenterological Association 2

For short transfers (<2 hours), TPN can be safely discontinued without significant nutritional impact, as recommended by the American Gastroenterological Association 2
For longer transfers, coordination between sending and receiving facilities is essential to minimize interruption of nutritional support, according to the American Gastroenterological Association 5
The receiving facility should be prepared to resume TPN promptly upon patient arrival, as suggested by the American Gastroenterological Association 5

Check recent laboratory values including electrolytes, glucose, and liver function tests before discontinuing TPN, as recommended by the American Gastroenterological Association 1
Ensure the patient has been on a stable TPN regimen without recent significant adjustments before discontinuing TPN, according to the American Gastroenterological Association 2
Document the exact TPN formulation and rate for the receiving facility, as suggested by the American Gastroenterological Association 2
Maintain hydration with appropriate intravenous fluids if needed during transfer, as recommended by the American Gastroenterological Association 2
For patients at higher risk of hypoglycemia, consider a maintenance dextrose infusion (D5W or D10W) during transfer, as noted by the Clinical Nutrition society 4
The receiving facility should promptly resume TPN using the same or equivalent formulation, according to the American Gastroenterological Association 5
When restarting TPN after a prolonged interruption, consider gradual reintroduction to prevent refeeding syndrome, as recommended by the American Gastroenterological Association 2
Monitor electrolytes, glucose, and fluid status closely after resuming TPN, as suggested by the American Gastroenterological Association 1