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NCAA Division I Men's Basketball Tournament bids by school
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This is a list of NCAA Men's Division I Basketball Tournament bids by school and is updated through 2018.[1] There are currently 68 bids possible each year (32 automatic qualifiers, 36 at-large). Schools not currently in Division I are in italics (e.g. CCNY) and some appear under prior names (e.g. UTEP went by Texas Western in 1966). Vacated appearances are excluded from the Bids table and noted below it.
Bids[edit]
As the tournament field started with only 8 teams in 1939 (all "Elite 8" by default), it was not until 1975 that all teams needed to win to advance to an alliteratively-named round (e.g. Elite 8, Sweet 16), hence some gaps may appear in the table for bids prior to 1951.
1939–1950: 8 teams
1951–1952: 16 teams
1953–1974: varied from 22 to 25 teams
1975–present: 32 or more teams
Please, note list is ordered by Bids then School when updating.
Bids by school
Most recent
Sweet 16
Elite 8
Final 4
Finals
Champions
#
School
Bid
Win
Last
#
Last
#
Last
#
Last
#
Last
#
57 Kentucky[2] 2018 2018 2018 43 2017 37 2015 17 2014 12 2012 8
49 North Carolina 2018 2018 2017 33 2017 28 2017 20 2017 11 2017 6
47 Kansas 2018 2018 2018 31 2018 24 2018 15 2012 9 2008 3
47 UCLA[3] 2018 2017 2017 33 2008 21 2008 17 2006 12 1995 11
42 Duke 2018 2018 2018 30 2018 21 2015 16 2015 11 2015 5
39 Indiana 2016 2016 2016 22 2002 11 2002 8 2002 6 1987 5
38 Louisville[4] 2017 2017 2009 24 2009 11 2005 8 1986 2 1986 2
37 Villanova[5] 2018 2018 2018 17 2018 13 2018 5 2018 3 2018 3
36 Notre Dame 2017 2017 2016 17 2016 7 1978 1
35 Syracuse[6][7] 2018 2018 2018 23 2016 10 2016 6 2003 3 2003 1
34 Texas 2018 2014 2008 10 2008 7 2003 3
33 Arizona[8] 2018 2017 2017 19 2015 11 2001 4 2001 2 1997 1
32 Arkansas 2018 2017 1996 11 1995 10 1995 6 1995 2 1994 1
32 Cincinnati 2018 2018 2012 13 1996 8 1992 6 1963 3 1962 2
32 Connecticut[9] 2016 2016 2014 17 2014 11 2014 5 2014 4 2014 4
32 Marquette[10] 2017 2013 2013 16 2013 7 2003 3 1977 2 1977 1
32 Michigan State 2018 2018 2015 19 2015 13 2015 9 2009 3 2000 2
32 Temple 2016 2013 2001 7 2001 8 1958 2
31 Oklahoma 2018 2016 2016 10 2016 9 2016 5 1988 2
30 Georgetown 2015 2015 2007 11 2007 9 2007 5 1985 4 1984 1
30 Illinois 2013 2013 2005 11 2005 9 2005 5 2005 1
30 Kansas State 2018 2018 2018 17 2018 13 1964 4 1951 1
29 BYU 2015 2012 2011 7 1981 3
29 Purdue[11] 2018 2018 2018 11 2000 4 1980 2 1969 1
29 Utah 2016 2016 2015 16 1998 6 1998 4 1998 2 1944 1
29 West Virginia 2018 2018 2018 11 2010 3 2010 2 1959 1
28 Ohio State[12] 2018 2018 2013 14 2012 14 2012 10 2007 5 1960 1
28 Oklahoma State 2017 2009 2005 11 2004 11 2004 6 1949 3 1946 2
28 St. John's[13] 2015 2000 1999 9 1999 6 1985 2 1952 1
28 Xavier 2018 2018 2017 8 2017 3
26 Maryland[14] 2017 2016 2016 14 2002 4 2002 2 2002 1 2002 1
26 Missouri[15] 2018 2010 2009 6 2009 4
26 Pittsburgh 2016 2014 2009 7 2009 3 1941 1
25 Iowa 2016 2016 1999 8 1987 4 1980 3 1956 1
25 North Carolina State[16] 2018 2015 2015 11 1986 6 1983 3 1983 2 1983 2
25 Princeton 2017 1998 1967 6 1965 1 1965 1
24 Michigan[17] 2018 2018 2018 14 2018 13 2018 6 2018 4 1989 1
24 Pennsylvania 2018 1994 1979 5 1979 3 1979 1
23 Wake Forest 2017 2010 2004 9 1996 6 1962 1
23 Wisconsin 2017 2017 2017 10 2015 6 2015 4 2015 2 1941 1
22 Virginia 2018 2017 2016 9 2016 6 1984 2
22 Western Kentucky[18] 2013 2012 2008 6 1940 1
21 Creighton 2018 2014 1974 3 1941 1
21 Gonzaga 2018 2018 2018 9 2017 3 2017 1 2017 1
21 LSU 2015 2009 2006 9 2006 6 2006 4
21 New Mexico State[19] 2018 1993 1992 4 1970 1 1970 1
21 Tennessee 2018 2018 2014 7 2010 1
20 Alabama[20] 2018 2018 2004 7 2004 1
20 Houston 2018 2018 1984 10 1984 5 1984 5 1984 2
20 Memphis[21] 2014 2014 2009 6 2007 4 1973 1 1973 1
20 Providence 2018 2016 1997 5 1997 4 1987 2
20 Saint Joseph's[22] 2016 2016 2004 6 2004 2
20 UNLV 2013 2008 2007 10 1991 5 1991 4 1990 1 1990 1
20 Utah State 2011 2001 1970 3 1970 2
19 Florida[23] 2018 2018 2017 10 2017 9 2014 5 2007 3 2007 2
19 Iowa State 2017 2017 2016 5 2000 2 1944 1
18 Boston College 2009 2007 2006 9 1994 3
18 California[24] 2016 2013 1997 4 1960 3 1960 3 1960 2 1959 1
18 Dayton 2017 2015 2014 7 2014 3 1967 1 1967 1
18 DePaul[25] 2004 2004 1984 8 1979 3 1979 2
17 Miami (OH) 2007 1999 1999 4
17 Southern California[26] 2017 2017 2007 4 2001 3 1954 2
17 Stanford 2014 2014 2014 5 2001 3 1998 2 1942 1 1942 1
17 UTEP 2010 1992 1992 4 1966 1 1966 1 1966 1 1966 1
16 Butler 2018 2018 2017 6 2011 2 2011 2 2011 2
16 Florida State 2018 2018 2018 5 2018 3 1972 1 1972 1
16 Georgia Tech 2010 2010 2004 7 2004 4 2004 2 2004 1
16 Murray State 2018 2012
16 Oregon 2017 2017 2017 6 2017 7 2017 2 1939 1 1939 1
16 San Francisco 1998 1979 1979 12 1974 7 1957 3 1956 2 1956 2
16 Tulsa 2016 2003 2000 4 2000 1
16 VCU 2017 2016 2011 1 2011 1 2011 1
16 Washington 2011 2011 2010 7 1953 3 1953 1
16 Weber State 2016 1999 1972 2
15 New Mexico 2014 2012 1974 2
15 Texas Tech[27] 2018 2018 2018 4 2018 1
15 UAB 2015 2015 2004 3 1982 1
15 Vanderbilt 2017 2012 2007 6 1965 1
15 Wichita State 2018 2017 2015 6 2013 4 2013 2
15 Wyoming 2015 2002 1987 4 1952 5 1943 1 1943 1 1943 1
14 Arizona State 2018 2009 1975 4 1975 3
14 Colorado 2016 2012 1969 5 1963 6 1955 2
14 Davidson 2018 2008 2008 4 2008 3
14 Oregon State[28] 2016 1975 1975 5 1975 5 1963 2
14 Texas A&M 2018 2018 2018 5
13 Holy Cross 2016 2016 1953 1 1953 4 1948 2 1947 1 1947 1
13 Ohio 2012 2012 2012 3 1964 1
13 Pepperdine 2002 2000 1976 2
12 Iona[29] 2018
12 La Salle 2013 2013 2013 3 1955 2 1955 2 1955 2 1954 1
12 Old Dominion 2011 2010
12 San Diego State 2018 2015 2014 2
12 Seton Hall 2018 2018 2000 4 1991 2 1989 1 1989 1
12 SMU 2017 1988 1967 6 1967 2 1956 1
11 Baylor 2017 2017 2017 4 2012 4 1950 2 1948 1
11 Charlotte 2005 2001 1977 1 1977 1 1977 1
11 Chattanooga 2016 1997 1997 1
11 Clemson[30] 2018 2018 2018 3 1980 1
11 George Washington 2014 2006 1993 1
11 Idaho State 1987 1977 1977 5 1977 1
11 Montana 2018 2006 1975 1
11 Navy 1998 1986 1986 3 1986 2
11 Oklahoma City 1973 1973 1965 5 1957 3
11 Santa Clara 1996 1996 1970 7 1969 5 1952 1
11 Seattle 1969 1964 1964 5 1958 1 1958 1 1958 1
10 Colorado State 2013 2013 1969 2 1969 1
10 East Tennessee State 2017 1992 1968 1
10 Georgia[31] 2015 2002 1996 2 1983 1 1983 1
10 Miami (FL) 2018 2016 2016 3
10 Mississippi State 2009 2008 1996 3 1996 1 1996 1
10 North Carolina A&T 2013 2013
10 Rhode Island 2018 2018 1998 2 1998 1
10 Southern Illinois 2007 2007 2007 3
10 Virginia Tech 2018 2007 1967 1 1967 1
10 Winthrop 2017 2007
9 Auburn 2018 2018 2003 4 1986 1
9 Middle Tennessee 2017 2017
9 Minnesota[32] 2017 2013 1990 3 1990 1
9 Pacific 2013 2005 1971 3 1967 1
9 Penn State 2011 2001 2001 4 1954 2 1954 1
9 Richmond 2011 2011 2011 2
9 Saint Louis 2014 2014 1957 2 1952 1
9 Saint Mary's 2017 2017 2010 2 1959 1
9 South Carolina 2017 2017 2017 4 2017 1 2017 1
9 Southern 2016 1993
9 Valparaiso 2015 1998 1998 1
8 Bradley 2006 2006 2006 3 1955 3 1954 2 1954 2
8 Bucknell 2018 2006
8 Eastern Kentucky 2014
8 Manhattan 2015 2004 1958 1
8 Massachusetts[33] 2014 1995 1995 2 1995 1
8 Mississippi 2015 2015 2001 1
8 Morehead State 2011 2011 1961 2
8 Nevada 2018 2018 2018 2
8 Northeastern 2015 1984
8 Northern Iowa 2016 2016 2010 1
8 Robert Morris 2015 2015
8 South Alabama 2008 1989
8 TCU 2018 1987 1968 4 1968 1
8 Texas Southern 2018 2018
7 Ball State 2000 1990 1990 1
7 Belmont 2015
7 Boise State 2015
7 Boston University 2011 1959 1959 1 1959 1
7 Dartmouth 1959 1958 1958 2 1958 5 1944 2 1944 2
7 LIU Brooklyn 2018
7 Louisiana-Monroe 1996
7 Nebraska 2014
7 St. Bonaventure 2018 2018 1970 3 1970 1 1970 1
6 Alcorn State 2002 1984
6 Austin Peay[34] 2016 1987
6 Detroit 2012 1999 1977 1
6 Furman 1980 1974 1974 1
6 George Mason 2011 2011 2006 1 2006 1 2006 1
6 Hampton 2016 2015
6 Illinois State 1998 1998
6 Kent State 2017 2002 2002 1 2002 1
6 Lamar 2012 1983 1980 1
6 Long Beach State[35] 2012 1970 1970 1
6 Louisiana-Lafayette[36] 2014 1992
6 Loyola-Chicago 2018 2018 2018 4 2018 2 2018 2 1963 1 1963 1
6 Missouri State 1999 1999 1999 1
6 NYU 1963 1963 1963 3 1960 4 1960 2 1945 1
6 Rutgers 1991 1983 1979 2 1976 1 1976 1
6 Siena 2010 2009
6 UNC Wilmington 2017 2002
6 Vermont 2017 2012
6 Washington State 2008 2008 2008 1 1941 1 1941 1 1941 1
5 Albany 2015 2014
5 Charleston 2018 1997
5 Cornell 2010 2010 2010 2
5 Delaware 2014
5 Duquesne 1977 1969 1969 2 1952 2 1940 1
5 Evansville 1999 1989
5 Fairleigh Dickinson 2016
5 Fresno State[37] 2016 2001 1982 1
5 Green Bay 2016 1994
5 Harvard 2015 2014 1946 1
5 Hawaiʻi 2016 2016
5 Jacksonville 1986 1970 1970 1 1970 1 1970 1 1970 1
5 James Madison 2013 2013
5 Lehigh 2012 2012
5 Little Rock 2016 2016
5 Louisiana Tech 1991 1989 1985 1
5 Marshall[38] 2018 2018
5 Mississippi Valley State 2012
5 Mount Saint Mary's 2017 2017
5 New Orleans 2017 1987
5 Oral Roberts 2008 1974 1974 1 1974 1
5 South Carolina State 2003
5 South Dakota State 2018
5 Stephen F. Austin 2018 2016
5 UC Santa Barbara 2011 1990
4 Air Force 2006
4 Akron 2013
4 Alabama State 2011
4 Bowling Green 1968 1963 1963 1
4 Canisius 1996 1957 1957 3 1956 2
4 Central Florida 2005
4 Central Michigan 2003 2003 1975 1
4 Coastal Carolina 2015
4 Coppin State 2008 1997
4 Drake 2008 1971 1971 3 1971 3 1969 1
4 Drexel 1996 1996
4 Eastern Michigan 1998 1996 1991 1
4 Fordham 1992 1971 1971 1
4 Georgia State 2018 2015
4 Hofstra 2001
4 Idaho 1990 1982 1982 1
4 Indiana State 2011 2001 1979 1 1979 1 1979 1 1979 1
4 Lafayette 2015 1957 1957 1
4 Loyola Marymount[39] 1990 1990 1990 2 1990 1
4 Milwaukee 2014 2006 2005 1
4 Monmouth 2006 2006
4 Rice 1970 1954 1954 1 1942 2
4 San Diego 2008 2008
4 Toledo 1980 1979 1979 1
4 UNC Asheville 2016 2011
4 UTSA 2011 2011
4 Western Michigan 2014 1998 1976 1
4 Wofford 2015
4 Yale 2016 2016 1949 1
3 American 2014
3 Buffalo 2018 2018
3 Cal State Fullerton 2018 1978 1978 1 1978 1
3 Central Connecticut State 2007
3 Columbia 1968 1968 1968 2 1948 1
3 Fairfield 1997
3 Florida A&M 2007 2004
3 Florida Gulf Coast 2017 2016 2013 1
3 Georgia Southern 1992
3 Jackson State 2007
3 Liberty 2013
3 Loyola (LA) 1958
3 Mercer 2014 2014
3 Montana State 1996 1951 1
3 Niagara 2007 2007 1970 1
3 North Carolina Central 2018
3 North Dakota State 2015 2014
3 North Texas 2010
3 Northern Illinois 1996
3 Northwestern State 2013 2006
3 Oakland 2011 2005
3 Radford 2018 2018
3 Rider 1994
3 Saint Peter's 2011
3 San José State 1996 1951 1
3 South Florida 2012 2012
3 Southern Miss 2012
3 Tulane 1995 1995
3 UIC 2004
3 UNC Greensboro 2018
3 VMI 1977 1977 1977 2 1976 1
3 Wright State 2018
2 Appalachian State 2000
2 Brown 1986 1939 1
2 Cal State Northridge 2009
2 CCNY 1950 1950 1950 2 1950 1 1950 1 1950 1
2 Cleveland State 2009 2009 1986 1
2 Colgate 1996
2 East Carolina 1993
2 Eastern Illinois 2001
2 Eastern Washington 2015
2 Hardin-Simmons 1957
2 Howard 1992
2 Loyola (MD) 2012
2 Marist 1987
2 McNeese State 2002
2 Morgan State 2010
2 Nicholls State 1998
2 Northern Arizona 2000
2 Portland 1996
2 Portland State 2009
2 Sam Houston State 2010
2 Samford 2000
2 Tennessee State 1994
2 Tennessee Tech 1963
2 Texas State 1997
2 Towson 1991
2 Troy 2017
2 UMBC 2018 2018
1 Alabama A&M 2005
1 Arkansas State 1999
1 Binghamton 2009
1 Cal Poly 2014 2014
1 Cal State Bakersfield 2016
1 Cal State LA 1974
1 Campbell 1992
1 Catholic 1944 1944 1
1 Charleston Southern 1997
1 Delaware State 2005
1 Florida Atlantic 2002
1 Florida International 1995
1 Houston Baptist 1984
1 IUPUI 2003
1 Jacksonville State 2017
1 Lebanon Valley 1953 1953 1953 1
1 Lipscomb 2018
1 Norfolk State 2012 2012
1 North Dakota 2017
1 North Florida 2015
1 Northern Colorado 2011
1 Northern Kentucky 2017
1 Northwestern 2017 2017
1 Prairie View A&M 1998
1 Saint Francis (PA) 1991
1 Southeast Missouri State 2000
1 Southeastern Louisiana 2005
1 Southern Utah 2001
1 Springfield 1940 1940 1
1 Stony Brook 2016
1 Texas A&M-Corpus Christi 2007
1 Texas-Arlington 2008
1 Trinity 1969
1 Tufts 1945 1945 1
1 UC Davis 2017 2017
1 UC Irvine 2015
1 Wagner 2003
1 Wayne State (MI) 1956 1956 1956 1
1 West Texas A&M 1955
1 Western Carolina 1996
1 Williams 1955
#
School
Bid
Win
Last
#
Last
#
Last
#
Last
#
Last
#
Bids by school
Most recent
Sweet 16
Elite 8
Final 4
Finals
Champions
References[edit]
Jump up ^ "2018 MEN'S FINAL FOUR RECORDS BOOK" (PDF). Retrieved March 4, 2018.
Jump up ^ Kentucky vacated the results of its 1988 NCAA tournament appearance in which it reached the Sweet Sixteen.
Jump up ^ UCLA vacated the results of its 1980 and 1999 NCAA tournament appearances as well as its finals appearance in 1980.
Jump up ^ On February 20, 2018, the NCAA announced that Louisville had to vacate wins and records from the 2011-12, 2012-13, 2013-14, and 2014-15 seasons.
Jump up ^ Villanova vacated the results of its 1971 NCAA tournament appearance along with its championship game appearance that year.
Jump up ^ Syracuse vacated 4 appearances in the 2005, 2006, 2011 and 2012 NCAA Tournaments
Jump up ^ "Syracuse University Public Infractions Decision" (PDF). Retrieved March 9, 2016.
Jump up ^ Arizona vacated the results of its 1999 and 2008 NCAA tournament appearances.
Jump up ^ Connecticut vacated the results of the 1996 NCAA tournament appearance and its Sweet Sixteen appearance that season.
Jump up ^ Marquette turned down an invite to the NCAA tournament in 1970 that would make 33 appearances.
Jump up ^ Purdue vacated the results of the 1996 NCAA tournament which it reached the round of 32.
Jump up ^ Ohio State vacated the results of its 1999, 2000, 2001, and 2002 NCAA tournament appearances, in which it reached the Final Four in 1999 and the round of 32 in 2000 and 2002.
Jump up ^ St. John's vacated the results of its 2002 NCAA tournament appearance.
Jump up ^ Maryland vacated the results of its 1988 NCAA tournament appearance in which it reached the round of 32.
Jump up ^ Missouri vacated the results of its 1994 NCAA tournament appearance in which it reached the Elite Eight.
Jump up ^ NC State vacated the results of the 1987 and 1988 NCAA tournament appearances.
Jump up ^ Michigan vacated the results of 113 games won while four players were not eligible, including the 1992 and 1993 Final Fours, and NCAA tournament appearances in 1992, 1993, 1996 and 1998.
Jump up ^ Western Kentucky vacated the results of the 1971 tournament, in which it reached the Final Four.
Jump up ^ New Mexico State vacated the results of the 1992, 1993 and 1994 NCAA tournaments which it reached the Sweet Sixteen (1992 and round of 32 (1993.
Jump up ^ Alabama vacated the results of the 1987 tournament.
Jump up ^ Memphis vacated tournament appearances for 1982, 1983, 1984, 1985, 1986 and 2008 for NCAA violations. This included Final Fours in 1985 and 2008 and the 2008 Finals appearance.
Jump up ^ Saint Joseph's vacated the results of its 1961 NCAA tournament which it reached the Final Four
Jump up ^ Florida vacated the results of the 1987 and 1988 NCAA tournaments.
Jump up ^ California vacated the results of its 1996 NCAA tournament appearance.
Jump up ^ DePaul vacated the results of NCAA tournament appearances in 1986, 1987, 1988, and 1989. It reached the Sweet Sixteen during the first two tournaments and the round of 32 for the last two tournaments.
Jump up ^ USC vacated the results of the 2008 tournament.
Jump up ^ Texas Tech vacated the results of the 1996 NCAA tournament
Jump up ^ Oregon State vacated the results of the 1980, 1981 and 1982 NCAA tournaments.
Jump up ^ Iona vacated the results of the 1980 NCAA tournament.
Jump up ^ Clemson vacated the results of the 1990 NCAA tournament.
Jump up ^ Georgia vacated the results of the 1985 and 2002 NCAA tournaments.
Jump up ^ Minnesota vacated the results of the 1972, 1994, 1995, and 1997 NCAA tournaments.
Jump up ^ Massachusetts vacated the results of the 1996 NCAA tournament, in which it advanced to the Final Four.
Jump up ^ Austin Peay vacated the results of the 1973 tournament.
Jump up ^ Long Beach State vacated the results of the 1971, 1972 and 1973 NCAA tournaments.
Jump up ^ ULL vacated the results of NCAA tournament appearances in 1972, 1973, 2004, and 2005.
Jump up ^ Fresno State vacated the results of the 2000 tournament.
Jump up ^ Marshall vacated the results of the 1987 tournament.
Jump up ^ Loyola Maryount vacated the results of the 1980 tournament.
See also[edit]
NCAA Division I Women's Basketball Tournament bids by school
NIT bids by school
CBI bids by school
CIT bids by school
[hide]
v
t
e
NCAA Division I Men's Basketball Tournament
Tournaments
1939
1940
1941
1942
1943
1944
1945
1946
1947
1948
1949
1950
1951
1952
1953
1954
1955
1956
1957
1958
1959
1960
1961
1962
1963
1964
1965
1966
1967
1968
1969
1970
1971
1972
1973
1974
1975
1976
1977
1978
1979
1980
1981
1982
1983
1984
1985
1986
1987
1988
1989
1990
1991
1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
Structure
Selection process
Venues
#1 seeds
Opening Round
Elite Eight
Final Four
National Championship Game
Champions & awards
Champions
Most Outstanding Player
Media & culture
Bracketology
Broadcasting
Tournament
Final Four
March Madness pools
"One Shining Moment"
Records & statistics
All-time team records
Bids by school
Bids by school and conference
Consecutive appearances
Final Four appearances by school
Final Four participants
Final Four appearances by coach
Upsets
Retrieved from "https://en.wikipedia.org/w/index.php?title=NCAA_Division_I_Men%27s_Basketball_Tournament_bids_by_school&oldid=836509281"
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Parenteral nutrition
From Wikipedia, the free encyclopedia
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Parenteral nutrition
Home TPN formula
[edit on Wikidata]
Total parenteral nutrition (PN) is the feeding of a person intravenously, bypassing the usual process of eating and digestion. The person receives nutritional formulae that contain nutrients such as glucose, salts, amino acids, lipids and added vitamins and dietary minerals. It is called total parenteral nutrition (TPN) or total nutrient admixture (TNA) when no significant nutrition is obtained by other routes, and partial parenteral nutrition (PPN) when nutrition is also partially enteric. It may be called peripheral parenteral nutrition (PPN) when administered through vein access in a limb rather than through a central vein as central venous nutrition (CVN).
Contents
[hide]
1 Medical uses
1.1 Gastrointestinal disorders
1.2 In cancer
2 Duration
2.1 Living with TPN
3 Complications
3.1 Infection
3.2 Blood clots
3.3 Fatty liver and liver failure
3.4 Hunger
3.5 Cholecystitis
3.6 Gut atrophy
3.7 Other complications
3.8 Pregnancy
4 Total parenteral nutrition
5 Components
5.1 Prepared solutions
5.2 Added components
5.3 Emulsifier
6 History
7 See also
8 References
9 External links
Medical uses[edit]
Total parenteral nutrition (TPN) is provided when the gastrointestinal tract is nonfunctional because of an interruption in its continuity (it is blocked, or has a leak - a fistula) or because its absorptive capacity is impaired.[1] It has been used for comatose patients, although enteral feeding is usually preferable, and less prone to complications. Parenteral nutrition is used to prevent malnutrition in patients who are unable to obtain adequate nutrients by oral or enteral routes.[2]
Gastrointestinal disorders[edit]
TPN may be the only feasible option for providing nutrition to patients who do not have a functioning gastrointestinal tract or who have disorders requiring complete bowel rest, including bowel obstruction,[3] short bowel syndrome,[3] gastroschisis,[3] prolonged diarrhea regardless of its cause,[3] high-output fistula,[3] very severe Crohn's disease[3] or ulcerative colitis,[3] and certain pediatric GI disorders including congenital GI anomalies and necrotizing enterocolitis.[4]
In cancer[edit]
The benefit of TPN to cancer patients is largely debated, and studies to date have generally showed minimal long term benefit. On the other hand, there is no evidence to support the idea that intravenous nutrition 'feeds the cancer, not the patient'.[citation needed]
Duration[edit]
Short-term PN may be used if a person's digestive system has shut down (for instance by peritonitis), and they are at a low enough weight to cause concerns about nutrition during an extended hospital stay. Long-term PN is occasionally used to treat people suffering the extended consequences of an accident, surgery, or digestive disorder. PN has extended the life of children born with nonexistent or severely deformed organs.
Living with TPN[edit]
Approximately 40,000 people use TPN at home in the United States, and because TPN requires anywhere from 10–16 hours to be administered, daily life can be affected.[5] Although daily lifestyle can be changed, most patients agree that these changes are better than staying at the hospital.[6] Many different types of pumps exist to limit the time the patient is “hooked-up”. Usually a backpack pump is used, allowing for mobility. The time required to be connected to the IV is dependent on the situation of each patient; some require once a day, or five days a week.[5]
It is important for patients to avoid as much TPN related change as possible in their lifestyles. This allows for the best possible mental health situation; constantly being held down can lead to resentment and depression. Physical activity is also highly encouraged, but patients must avoid contact sports (equipment damage) and swimming (infection). Many teens find it difficult to live with TPN due to issues regarding body image and not being able to participate in activities and events.[5]
Complications[edit]
TPN fully bypasses the GI tract and normal methods of nutrient absorption. Possible complications, which may be significant, are listed below.
Infection[edit]
TPN requires a chronic IV access for the solution to run through, and the most common complication is infection of this catheter. Infection is a common cause of death in these patients, with a mortality rate of approximately 15% per infection, and death usually results from septic shock.[7]
Blood clots[edit]
Chronic IV access leaves a foreign body in the vascular system, and blood clots on this IV line are common.[8] Death can result from pulmonary embolism wherein a clot that starts on the IV line breaks off and travels to the lungs, blocking blood flow.[9]
Micrograph of periportal fatty liver as may arise due to TPN. Trichrome stain.
Patients on TPN who have such clots occluding their catheter may receive a thrombolytic flush to dissolve the clots and prevent further complications.
Fatty liver and liver failure[edit]
Fatty liver is usually a more long term complication of TPN, though over a long enough course it is fairly common. The pathogenesis is due to using linoleic acid (an omega-6 fatty acid component of soybean oil) as a major source of calories.[10][11] TPN-associated liver disease strikes up to 50% of patients within 5–7 years, correlated with a mortality rate of 2–50%. Onset of this liver disease is the major complication that leads TPN patients to requiring an intestinal transplant.[12]
Intralipid (Fresenius-Kabi), the US standard lipid emulsion for TPN nutrition, contains a 7:1 ratio of n-6/n-3 ratio of polyunsaturated fatty acids (PUFA). By contrast, Omegaven has a 1:8 ratio and showed promise in multiple clinical studies. Therefore n-3-rich fat may alter the course of parenteral nutrition associated liver disease.[13]
Hunger[edit]
Because patients are being fed intravenously, the subject does not physically eat, resulting in intense hunger pangs. The brain uses signals from the mouth (taste and smell), the stomach/G.I. tract (fullness) and blood (nutrient levels) to determine conscious feelings of hunger.[14] In cases of TPN, the taste, smell and physical fullness requirements are not met, and so the patient experiences hunger, despite the fact that the body is being fully nourished.
Patients who eat food despite the inability can experience a wide range of complications.[15]
Cholecystitis[edit]
Total parenteral nutrition increases the risk of acute cholecystitis[16] due to complete disuse of gastrointestinal tract, which may result in bile stasis in the gallbladder. Other potential hepatobiliary dysfunctions include steatosis,[17] steatohepatitis, cholestasis, and cholelithiasis.[18] Six percent of patients on TPN longer than 3 weeks and 100% of patients on TPN longer than 13 weeks develop biliary sludge. The formation of sludge is the result of stasis due to lack of enteric stimulation and is not due to changes in bile composition. Gallbladder sludge disappears after 4 weeks of normal oral diet. Administration of exogenous cholecystokinin (CCK) or stimulation of endogenous CCK by periodic pulse of large amounts of amino acids have been shown to help prevent sludge formation. These therapies are not routinely recommended.[19] Such complications are suggested to be the main reason for mortality in people requiring long-term total parenteral nutrition, such as in short bowel syndrome.[20] In newborn infants with short bowel syndrome with less than 10% of expected intestinal length, thereby being dependent upon total parenteral nutrition, 5 year survival is approximately 20%.[21]
Gut atrophy[edit]
Infants who are sustained on TPN without food by mouth for prolonged periods are at risk for developing gut atrophy.[22]
Other complications[edit]
Other complications are either related to catheter insertion, or metabolic, including refeeding syndrome. Catheter complications include pneumothorax, accidental arterial puncture, and catheter-related sepsis. The complication rate at the time of insertion should be less than 5%.[23] Catheter-related infections may be minimised by appropriate choice of catheter and insertion technique.[24] Metabolic complications include the refeeding syndrome characterised by hypokalemia, hypophosphatemia and hypomagnesemia. Hyperglycemia is common at the start of therapy, but can be treated with insulin added to the TPN solution. Hypoglycaemia is likely to occur with abrupt cessation of TPN. Liver dysfunction can be limited to a reversible cholestatic jaundice and to fatty infiltration (demonstrated by elevated transaminases). Severe hepatic dysfunction is a rare complication.[25] Overall, patients receiving TPN have a higher rate of infectious complications. This can be related to hyperglycemia.[26]
Pregnancy[edit]
Pregnancy can cause major complications when trying to properly dose the nutrient mixture. Because all of the baby’s nourishment comes from the mother’s blood stream, the doctor must properly calculate the dosage of nutrients to meet both recipient’s needs and have them in usable forms. Incorrect dosage can lead to many adverse, hard-to-guess effects, such as death, and varying degrees of deformation or other developmental problems.[27]
It is recommended that parenteral nutrition administration begin after a period of natural nutrition so doctors can properly calculate the nutritional needs of the fetus. Otherwise, it should only be administered by a team of highly skilled doctors who can accurately assess the fetus’ needs.[27]
Total parenteral nutrition[edit]
Prescription lipid parenteral nutrition formulation
Solutions for total parenteral nutrition may be customized to individual patient requirements, or standardized solutions may be used. The use of standardized parenteral nutrition solutions is cost effective and may provide better control of serum electrolytes.[28] Ideally each patient is assessed individually before commencing on parenteral nutrition, and a team consisting of specialised doctors, nurses, clinical pharmacists and registered dietitians evaluate the patient's individual data and decide what PN formula to use and at what infusion rate.
For energy only, intravenous sugar solutions with dextrose or glucose are generally used. This is not considered to be parenteral nutrition as it does not prevent malnutrition when used on its own. Standardized solutions may also differ between developers. Following are some examples of what compositions they may have. The solution for normal patients may be given both centrally and peripherally.
Examples of total parenteral nutrition solutions[28]
Substance
Normal patient
High stress
Fluid-restricted
Amino acids 85 g 128 g 75 g
Dextrose 250 g 350 g 250 g
Lipids 100 g 100 g 50 g
Na+ 150 mEq 155 mEq 80 mEq
K+ 80 mEq 80 mEq 40 mEq
Ca2+ 360 mg 360 mg 180 mg
Mg2+ 240 mg 240 mg 120 mg
Acetate 72 mEq 226 mEq 134 mEq
Cl− 143 mEq 145 mEq 70 mEq
P 310 mg 465 mg 233 mg
MVI-12 10 mL 10 mL 10 mL
Trace elements 5 mL 5 mL 5 mL
Components[edit]
Prepared solutions[edit]
Prepared solutions generally consist of water and electrolytes; glucose, amino acids, and lipids; essential vitamins, minerals and trace elements are added or given separately. Previously lipid emulsions were given separately but it is becoming more common for a "three-in-one" solution of glucose, proteins, and lipids to be administered.[29][30]
Added components[edit]
Individual nutrient components may be added to more precisely adjust the body contents of it. That individual nutrient may, if possible, be infused individually, or it may be injected into a bag of nutrient solution or intravenous fluids (volume expander solution) that is given to the patient.
Administration of individual components may be more hazardous than administration of pre-mixed solutions such as those used in total parenteral nutrition, because the latter are generally already balanced in regard to e.g. osmolarity and ability to infuse peripherally. Incorrect IV administration of concentrated potassium can be lethal, but this is not a danger if the potassium is mixed in TPN solution and diluted.[31]
Vitamins may be added to a bulk premixed nutrient immediately before administration, since the additional vitamins can promote spoilage of stored product[citation needed]. Vitamins can be added in two doses, one fat-soluble, the other water-soluble. There are also single-dose preparations with both fat- and water-soluble vitamins such as Cernevit.[32][33]
Minerals and trace elements for parenteral nutrition are available in prepared mixtures, such as Addaven.[34]
Emulsifier[edit]
Only a limited number of emulsifiers are commonly regarded as safe to use for parenteral administration, of which the most important is lecithin.[medical citation needed] Lecithin can be biodegraded and metabolized, since it is an integral part of biological membranes, making it virtually non-toxic. Other emulsifiers can only be excreted via the kidneys,[citation needed] creating a toxic load. The emulsifier of choice for most fat emulsions used for parenteral nutrition is a highly purified egg lecithin,[35] due to its low toxicity and complete integration with cell membranes.
Use of egg-derived emulsifiers is not recommended for people with an egg allergy due to the risk of reaction. In situations where there is no suitable emulsifying agent for a person at risk of developing essential fatty acid deficiency, cooking oils may be spread upon large portions of available skin for supplementation by transdermal absorption.
Another type of fat emulsion Omegaven is being used experimentally within the US primarily in the pediatric population. It is made of fish oil instead of the egg based formulas more widely in use. Research has shown use of Omegaven may reverse and prevent liver disease and cholestasis.[36]
History[edit]
This section relies too much on references to primary sources. Please improve this section by adding secondary or tertiary sources. (April 2014) (Learn how and when to remove this template message)
Developed in the 1960s by Dr. Stanley J. Dudrick, who as a surgical resident in the University of Pennsylvania, working in the basic science laboratory of Dr. Jonathan Rhoads, was the first to successfully nourish initially Beagle puppies and subsequently newborn babies with catastrophic gastrointestinal malignancies.[37] Dr. Dudrick collaborated with Dr. Willmore and Dr. Vars to complete the work necessary to make this nutritional technique safe and successful.[38]
See also[edit]
Feeding tube
Hickman line
Intradialytic parenteral nutrition
Intravenous therapy
References[edit]
Jump up ^ Kozier, B., & Erb, G., & Berman, A.J., & Burke, K., & Bouchal, S. R., & Hirst, S. P.. (2004). Fundamentals of Nursing: The Nature of Nursing Practice in Canada. Canadian Edition. Prentice Hall Health: Toronto.
Jump up ^ American Gastroenterological Association medical position statement: parenteral nutrition
^ Jump up to: a b c d e f g The Merck Manual, 2008
Jump up ^ Heird, WC; Gomez, MR (June 1994). "Total parenteral nutrition in necrotizing enterocolitis". Clinics in perinatology. 21 (2): 389–409. PMID 8070233.
^ Jump up to: a b c Yaworski, J.A. "Total Parenteral Nutrition (TPN) Frequently Asked Questions". Children's Hospital of Pittsburgh. Retrieved 30 March 2014.
Jump up ^ "Living with total parenteral nutrition (TPN) at home". Great Ormund Street Hospital for Children. Retrieved 30 March 2014.
Jump up ^ Deshpande, KS (July 2003). "Total parenteral nutrition and infections associated with use of central venous catheters". American Journal of Critical Care. 12 (4): 326–7, 380. PMID 12882062.
Jump up ^ Mollitt, DL; Golladay ES. (August 1983). "Complications of TPN catheter-induced vena caval thrombosis in children less than one year of age". Journal of pediatric surgery. 18 (4): 462–7. doi:10.1016/S0022-3468(83)80201-2. PMID 6413671.
Jump up ^ Mailloux, RJ; DeLegge, MH; Kirby, DF (Nov–Dec 1993). "Pulmonary embolism as a complication of long-term total parenteral nutrition". JPEN. Journal of parenteral and enteral nutrition. 17 (6): 578–82. doi:10.1177/0148607193017006578. PMID 8301814.
Jump up ^ "Evaluation of OMEGAVEN 10%® (n-3 EFA Lipid Emulsion) in Home Parenteral Nutrition-associated Liver Disease (MEGANORM)". Retrieved 15 April 2013.
Jump up ^ Piper, SN; Rohm KD (Dec 2009). "Hepatocellular integrity after parenteral nutrition: comparison of a fish-oil-containing lipid emulsion with an olive-soybean oil-based lipid emulsion". Eur J Anaesthesiol. 26 (12): 1076–82. doi:10.1097/EJA.0b013e32832e08e0. PMID 19916246.
Jump up ^ Garg, M. Jones, R. M., Vaughan, R. B., Testro, A. G. (2011). Intestinal transplantation: Current status and future directions. Journal of Gastroenterology and Hepatology, 26, 1221-1228
Jump up ^ Kumar Jain, Ajay; Teckman, Jeffrey H. (2014). "Newly Identified Mechanisms of Total Parenteral Nutrition Related Liver Injury". Advances in Hepatology. 2014: 1–7. doi:10.1155/2014/621380. ISSN 2356-6744.
Jump up ^ Hunger (motivational state)
Jump up ^ "Bowel Obstruction". Women's Health. Retrieved 30 March 2014.
Jump up ^ Tucker, RA; Jenkins, HL (1984). "Acalculous cholecystitis and fever related to total parenteral nutrition". Drug intelligence & clinical pharmacy. 18 (11): 897–9. PMID 6437783.
Jump up ^ Wang, H; Khaoustov, VI; Krishnan, B; Cai, W; Stoll, B; Burrin, DG; Yoffe, B (October 2006). "Total parenteral nutrition induces liver steatosis and apoptosis in neonatal piglets". The Journal of Nutrition. 136 (10): 2547–52. PMID 16988124.
Jump up ^ Quigley EM, Marsh MN, Shaffer JL, Markin RS (January 1993). "Hepatobiliary complications of total parenteral nutrition". Gastroenterology. 104 (1): 286–301. PMID 8419252.
Jump up ^ http://www.bcm.edu/gastro/VGICC/GI-M0054/09-DISC.HTM
Jump up ^ Vanderhoof JA, Langnas AN (1997). "Short-bowel syndrome in children and adults". Gastroenterology. 113 (5): 1767–78. doi:10.1053/gast.1997.v113.pm9352883. PMID 9352883.
Jump up ^ Spencer AU, Neaga A, West B, et al. (September 2005). "Pediatric short bowel syndrome: redefining predictors of success". Ann. Surg. 242 (3): 403–9; discussion 409–12. doi:10.1097/01.sla.0000179647.24046.03. PMC 1357748  . PMID 16135926. (mean follow-up time was 5.1 years)
Jump up ^ Strodtbeck, Frances (June 2003). "The pathophysiology of prolonged periods of no enteral nutrition or nothing by mouth". Newborn & Infant Nursing Reviews. Elsevier. 3 (2): 47–54. doi:10.1016/S1527-3369(03)00005-9. Retrieved 4 January 2016.
Jump up ^ McGee DC, Gould MK (March 2003). "Preventing complications of central venous catheterization". N. Engl. J. Med. 348 (12): 1123–33. doi:10.1056/NEJMra011883. PMID 12646670.
Jump up ^ Horattas MC, Trupiano J, Hopkins S, Pasini D, Martino C, Murty A (February 2001). "Changing concepts in long-term central venous access: catheter selection and cost savings". Am J Infect Control. 29 (1): 32–40. doi:10.1067/mic.2001.111536. PMID 11172316.
Jump up ^ G. Edward Morgan, Jr., Maged S. Mikhail, Michael J. MurrayClinical Anesthesiology, 4th Edition
Jump up ^ McCowen, KC; Friel, C; Sternberg, J; Chan, S; Forse, RA; Burke, PA; Bistrian, BR (2000). "Hypocaloric total parenteral nutrition: effectiveness in prevention of hyperglycemia and infectious complications--a randomized clinical trial" (PDF). Critical Care Medicine. 28 (11): 3606–11. doi:10.1097/00003246-200011000-00007. PMID 11098961.
^ Jump up to: a b Landon, MB; Gabbe, SG; Mullen, JL (1986). "Total parenteral nutrition during pregnancy". Clin Perinatol. 13 (1): 57–72. PMID 3082563.
^ Jump up to: a b Hayes, EM; Cohen KR; Pinard BE; Lauletta J; Ruggiero R. (2000). "Standardized versusindividually customized parenteral nutrition solutions: a comparison ofserum electrolyte values" (PDF). P&T. 25 (2): 78–80, 83, 87.
Jump up ^ Didier ME, Fischer S, Maki DG (1998). "Total nutrient admixtures appear safer than lipid emulsion alone as regards microbial contamination: growth properties of microbial pathogens at room temperature". JPEN J Parenter Enteral Nutr. 22 (5): 291–6. doi:10.1177/0148607198022005291. PMID 9739032.
Jump up ^ Rollins CJ, Elsberry VA, Pollack KA, Pollack PF, Udall JN (1990). "Three-in-one parenteral nutrition: a safe and economical method of nutritional support for infants". JPEN J Parenter Enteral Nutr. 14 (3): 290–4. doi:10.1177/0148607190014003290. PMID 2112645.
Jump up ^ Intravenous Potassium Guidelines (ADULTS) From RNSH Pharmacy Department. Authorised by: Margaret Duguid. Last Modified: June 2006.
Jump up ^ "Cernevit™-12 (multivitamins for infusion)" (PDF). Food and Drug Administration. 1999.
Jump up ^ "Cernevit" (PDF). NPS MedicineWise. October 2014.
Jump up ^ "Addaven Konzentrat zur Herstellung einer Infusionslösung". Wissenschaftliche Verlagsgesellschaft Stuttgart. 2015-10-26.
Jump up ^ Lecithin - An Emulsifier for Parenteral Use: TORVS Research Team
Jump up ^ "The use of Omegaven in treating parenteral nutrition-associated liver disease". J Perinatol. 31 Suppl 1: S57–60. 2011. doi:10.1038/jp.2010.182. PMID 21448206.
Jump up ^ Wilmore DW, Groff DB, Bishop HC, Dudrick SJ (Apr 1969). "Total parenteral nutrition in infants with catastrophic gastrointestinal anomalies". J Pediatr Surg. 4 (2): 181–9. doi:10.1016/0022-3468(69)90389-3. PMID 4976039.
Jump up ^ Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE (Jul 1968). "Long-term total parenteral nutrition with growth, development, and positive nitrogen balance". Surgery. 64 (1): 134–42.
External links[edit]
American Society for Parenteral and Enteral Nutrition
Oley Foundation for people who feed by tube or IV at home
Nutrishare Specialists in long-term home parenteral nutrition across the USA
Calculating Parenteral Feedings at California State University, San Bernardino
PINNT UK based support group for Patients on Intravenous and Nasogastric Nutrition Therapy
Nieman, Liesje (January 2008). "Parenteral Nutrition in the NICU" (PDF). NutritionDimension.com. Retrieved 16 April 2013. Course ID code: PNN07
Kimaya web application to calculate TPN
[hide]
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