What complication is commonly associated with total parenteral nutrition (TPN) and enteral feeding?

Total parenteral nutrition (TPN) and enteral feeding can lead to various complications, but hyperosmolar nonketotic coma is particularly associated with TPN due to its potential to lead to significant fluctuations in glucose levels and osmolarity. TPN solutions are typically high in glucose, and if not properly managed, patients can experience hyperglycemia. This condition, especially in patients who may be insulin-resistant or have undiagnosed diabetes, can become severe and lead to hyperosmolar nonketotic states.

In hyperosmolar nonketotic coma, the body’s inability to effectively manage high glucose levels can lead to severe dehydration and alterations in mental status, making this a critical consideration in patients receiving TPN. Close monitoring of blood glucose levels and awareness of the patient's baseline metabolic control are essential to prevent this complication.

While sepsis can be a complication associated with the use of TPN due to catheter-related infections, and hypoglycemia can occur with rapid changes in TPN administration, they are not as categorically linked to the specific biochemical milieu created by TPN as hyperosmolar nonketotic coma. Hyperkalemia may occur in some patients but is not a common direct complication of TPN; instead, it is often related