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TPN Control Needed

Michael A. Manko, MD
Arch Intern Med. 1977;137(12):1671-1672. doi:10.1001/archinte.1977.03630240007005.
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Total parenteral nutrition (TPN) has been increasingly used since 1968. It is now an established method of maintaining normal nitrogen balance in patients who otherwise would be unable to do so. The use of all forms of intravenous infusion therapy has been largely responsible for the success in treating critically ill patients. In this issue of the Archives (p 1686), Plouffe et al discuss an outbreak of infection caused by contamination of the system used in preparing infusion fluid. Although Candida albicans is the most common cause of fungemia complicating intravenous therapy, other species such as C parapsilosis have been isolated, and the clinical picture appears to be the same, regardless of which Candida species is responsible.1

Patients receiving hyperalimentation who develop candidemia usually clear the fungus from the blood shortly after the infusion catheter has been removed. Phagocytosis and the clumping factor in normal human serum destroys small


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