Cyclic PN

PN therapy may be infused continuously 24-h daily, or the same volume may be infused over a shorter period of time, such as a cycle of 12-h PN infusion and 12-h free of infusion. Infusion pumps can be programmed to adjust infusion rates according to the desired volumes and administration times. Continuous infusion is generally selected when PN is first initiated for an acutely ill patient. Benefits for a cyclic total PN regimen are particularly notable for long-term patients. A cycled PN regimen allows more mobility for the patient, thus enabling the patient to achieve a more active lifestyle. Limitations to a cycled PN regimen include fluid intolerance or glucose intolerance. When initiating a PN cycle, blood glucose concentrations should be checked to ensure that hyperglycemia or hypoglycemia is not an issue for the patient. Because of the potential for 'rebound hypoglycemia' upon abrupt cessation of infusion, the rate of administration is often tapered down at the end of the cycle to allow for downregulation of pancreatic release of insulin. Many infusion pumps have programmable taper functions.

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