Developing and Implementing All-in-One Standard Paediatric Parenteral Nutrition
Abstract
:1. Introduction
2. Methodology
2.1. Developing the Composition of the Standard PN
Component | Name | Manufacturer |
---|---|---|
Amino acids | Aminoven Infant 10% | Fresenius Kabi, Oberdorf, Switzerland |
Glucose | Glucose 50% | Grosse Apotheke Dr. Bichsel AG, Interlaken, Switzerland |
Lipids | SMOF Lipid | Fresenius Kabi, Oberdorf, Switzerland |
Vitamins | Soluvit N | Fresenius Kabi, Oberdorf, Switzerland |
Vitalipid N Infant | Fresenius Kabi, Oberdorf, Switzerland | |
Trace Elements | Peditrace | Fresenius Kabi, Oberdorf, Switzerland |
Sodium | Sodiumchloride (Concentration 59 mg/mL) | Manufactured in the hospital pharmacy |
Sodiumacetate (Concentration 1 mmol/mL) | Manufactured in the hospital pharmacy | |
Potassium | Potassiumchloride 7.45% | Sintetica, Mendrisio, Switzerland |
Magnesium | Magnesiumchloride 0.5 M | B. Braun, Sempach, Switzerland |
Phosphate | Glycophos | Fresenius Kabi, Oberdorf, Switzerland |
Calcium | Calcium Sandoz 10% | Sandoz Pharmaceuticals, Novartis, Switzerland |
2.2. Implementation of the Standard PN
2.3. Review of Usage
- How many were ordered?
- How many children required electrolyte corrections?
- How many children required an individual PN solution?
- If any ordering/compounding errors were made.
3. Results
3.1. Composition
Ped 1 | Ped 2 | Ped 3 | Ped 4 | |
---|---|---|---|---|
Birth–2 months | 2 months–10 kg | 11–16 kg | 16–30 kg | |
(1000 mL) | (1000 mL) | (1500 mL) | (2000 mL) | |
per 100 mL | per 100 mL | per 100 mL | per 100 mL | |
2.19 | 2.5 | 2.67 | 3.38 | |
Glucose (g) | 10.5 | 14.5 | 14.47 | 14 |
Lipids (g) | 2.5 | 2.8 | 3 | 3.5 |
Energy (kcal) | 67 | 85 | 87 | 93 |
Sodium (mmol) | 2.2 | 2.5 | 3 | 3.5 |
Potassium (mmol) | 1.48 | 2 | 2.53 | 3.3 |
Magnesium (mmol) | 0.15 | 0.2 | 0.19 | 0.18 |
Calcium (mmol) | 0.5 | 0.8 | 0.25 | 0.3 |
Phosphate (mmol) | 0.5 | 0.8 | 0.25 | 0.3 |
Chloride (mmol) | 1.8 | 2.42 | 3.92 | 5.12 |
Acetate (mmol) | 1.19 | 0.89 | 1.5 | 1.45 |
Vitalipid/Soluvit 1:1 (mL) | 1.92 | 1.33 | 0.85 | 0.7 |
8Peditrace (mL) | 1 | 1 | 1 | 1 |
Osmolarity (mOsmol/L) | 907 | 1185 | 1210 | 1280 |
ESPGHAN requirements [1] | Nutrients delivered | |
---|---|---|
80–120 | 90 | |
Protein (g) | 1.5–2.5 | 2.4 |
Glucose (g) | 12–14 | 13 |
Lipids (g) | 2–3 | 2.7 |
Energy (kcal) | 75–90 | 86 |
Sodium (mmol) | 2–3 | 2.7 |
Potassium (mmol) | 1–3 | 2.28 |
Magnesium (mmol) | 0.2 | 0.17 |
Calcium (mmol) | 0.2 | 0.23 |
Phosphate (mmol) | 0.2 | 0.23 |
Vitalipid/Soluvit 1:1 (mL) | 10 | 9 |
Peditrace (mL) | 15 | 9 |
3.2. Data on Ordering of Standard PN
AIO PN with/without electrolyte changes | Individual PN | |
---|---|---|
5 | 3 | |
Age in years (median) | 2.2 (range 0.8–5) | 12.6 (range 7–17) |
Gender | 2 male | 3 male |
Diagnosis | 4 short gut1 post gastrointestinal surgery | 3 graft versus host disease post bone marrow transplantation |
Electrolyte amendments/reason for individual PN | 4 required amended potassium1 required the removing of sodium acetate | All 3 had hyperglycaemia, hyperlipidaemia and significant electrolyte disturbances. |
4. Discussion
5. Conclusions
Implications
Acknowledgements
Conflict of Interest
References
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Meyer, R.; Timmermann, M.; Schulzke, S.; Kiss, C.; Sidler, M.A.; Furlano, R.I. Developing and Implementing All-in-One Standard Paediatric Parenteral Nutrition. Nutrients 2013, 5, 2006-2018. https://doi.org/10.3390/nu5062006
Meyer R, Timmermann M, Schulzke S, Kiss C, Sidler MA, Furlano RI. Developing and Implementing All-in-One Standard Paediatric Parenteral Nutrition. Nutrients. 2013; 5(6):2006-2018. https://doi.org/10.3390/nu5062006
Chicago/Turabian StyleMeyer, Rosan, Meike Timmermann, Sven Schulzke, Caroline Kiss, Marc A. Sidler, and Raoul I. Furlano. 2013. "Developing and Implementing All-in-One Standard Paediatric Parenteral Nutrition" Nutrients 5, no. 6: 2006-2018. https://doi.org/10.3390/nu5062006