<prompt> Best vein for total parenteral nutrition isSubclavian veinFemoral veinBrachial veinSaphenous vein  <response>: Ans. a Subclavian vein. Ref. Baily and Love surgery 25thpg. 231TOTAL PARENTERAL NUTRITIONDefined as the intravenous provision of all nutritional requirements, without the use of GIT.Indications: Proximal intestinal fistula Inflammatory bowel disease Massive intestinal resection especially if 100 cm of small bowel remains Ileus Pancreatitis severePreferred vein: Peripheral line for short period 2 weeks Central line for long periodCentral venous route is chosen more commonly, and the catheter should be inserted via either subclavian, internal external jugular vein should be avoided as it is associated with high incidence of infection and thrombosis. The catheter tip should be in distal SVC to minimize risk of central venous or cardiac thrombosis.Complications of TPN:Catheter relatedFeeding Regimen related Arterial, venous injuries and cardiac perforation and thrombosis Hyperglycemia Hypoglycemia Brachial plexus and stellate ganglion injury Hypertriglyceridemia Pneumothorax Hyperchloremic acidosis Thoracic duct injury Electrolyte imbalance Air embolism Trace element and vitamin deficiency Catheter related infections Catheter migrationembolus Thrombotic catheter occlusion SABE 