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Nutrients 2018, 10(2), 208; https://doi.org/10.3390/nu10020208

Calcium Chloride and Calcium Gluconate in Neonatal Parenteral Nutrition Solutions without Cysteine: Compatibility Studies Using Laser Light Obscuration Methodology

1
Northwest Newborn Specialists, PC and Pediatrix Medical Group, Portland, OR 97227, USA
2
Department of Pharmaceutical Sciences, College of Pharmacy, Oregon State University, Corvallis, OR 97331, USA
3
Neonatal Pharmacy, Randall Children’s Hospital at Legacy Emanuel, Portland, OR 97227, USA
*
Author to whom correspondence should be addressed.
Received: 21 December 2017 / Revised: 26 January 2018 / Accepted: 12 February 2018 / Published: 14 February 2018
(This article belongs to the Special Issue Advances in Parenteral Nutrition)
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Abstract

There are no compatibility studies for neonatal parenteral nutrition solutions without cysteine containing calcium chloride or calcium gluconate using light obscuration as recommended by the United States Pharmacopeia (USP). The purpose of this study was to do compatibility testing for solutions containing calcium chloride and calcium gluconate without cysteine. Solutions of TrophAmine and Premasol (2.5% amino acids), containing calcium chloride or calcium gluconate were compounded without cysteine. Solutions were analyzed for particle counts using light obscuration. Maximum concentrations tested were 15 mmol/L of calcium and 12.5 mmol/L of phosphate. If the average particle count of three replicates exceeded USP guidelines, the solution was determined to be incompatible. This study found that 12.5 and 10 mmol/L of calcium and phosphate, respectively, are compatible in neonatal parenteral nutrition solutions compounded with 2.5% amino acids of either TrophAmine or Premasol. There did not appear to be significant differences in compatibility for solutions containing TrophAmine or Premasol when solutions were compounded with either CaCl2 or CaGlu-Pl. This study presents data in order to evaluate options for adding calcium and phosphate to neonatal parenteral nutrition solutions during shortages of calcium and cysteine. View Full-Text
Keywords: calcium chloride; calcium gluconate; compatibility; neonates; parenteral nutrition calcium chloride; calcium gluconate; compatibility; neonates; parenteral nutrition
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Huston, R.K.; Christensen, J.M.; Alshahrani, S.M.; Mohamed, S.M.; Heisel, C.F. Calcium Chloride and Calcium Gluconate in Neonatal Parenteral Nutrition Solutions without Cysteine: Compatibility Studies Using Laser Light Obscuration Methodology. Nutrients 2018, 10, 208.

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