1. Stability of individualized neonatal parenteral nutrition admixtures with fish oil and high calcium content.
- Author
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Escuder-Vieco D, Gomis Muñoz P, Hernández Ramos JA, Bruni Montero MÁ, Bergón Sendín E, de la Cruz Bértolo J, and Bustos Lozano G
- Subjects
- Humans, Infant, Newborn, Calcium analysis, Calcium chemistry, Fat Emulsions, Intravenous chemistry, Drug Stability, Parenteral Nutrition, Total methods, Parenteral Nutrition methods, Particle Size, Emulsions, Parenteral Nutrition Solutions chemistry, Olive Oil, Soybean Oil, Triglycerides, Fish Oils chemistry, Fish Oils analysis
- Abstract
Introduction: Introduction: the stability of total parenteral nutrition admixtures for neonates (TPNAn) has been questioned in relation to the interaction between calcium and fish oil emulsions. Aim: the aim of this study was to check the stability (particle size < 1 µm) of different individualized TPNAn prepared with fish-oil emulsion and containing calcium at concentrations ranging from 10 to 20 mmol/L. Methods: admixtures analyzed: twelve different formulations with SMOFlipid® 20 % (conserved for 24 h and for 96 h), three formulations with Lipoplus® 20 % (conserved for 96 h) and three formulations with SMOFlipid® 20 % with Multi-12K1® Pediatric (conserved for 96 h). Two bags were compounded for each formulation and conservation period. Measurements on each admixture bag: particle standardized diameter by laser diffraction technique and pH by a calibrated pH-meter. Data analysis with mixed linear regression models. Results: maximum particle size was < 0.8 µm for all investigated admixtures. Lipid concentration of 5 g/L and sodium and potassium concentration of 100 mmol/L slightly increased the proportion of particles > 0.6 µm. Ninety six hours storage also increased the percentage of particles > 0.6 µm (+0.143 ± 0.07; p = 0.038) but did not influence other parameters. No association with calcium composition was observed. Amino acid content was inversely correlated with pH (-0.83; p < 0.0001). Conclusions: the studied individualized parenteral nutrition admixtures for newborns that contain fish oil emulsions and meet cation requirements are stable for at least 96 hours.
- Published
- 2024
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