Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design.
نویسندگان
چکیده
BACKGROUND/AIM Parenteral nutrition as a specific as pect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN) admixtures have complex con tents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5 microm and that the presence of greater droplets should not exceede the value of 0.05%. Lipid droplets size is affected particularly by electrolyte addition, especially polyvalent cations. There is a danger of the added electrolytes interaction with lipid droplets which leads to their aggregation and negative effects upon the admixtures stability. The aim of this study was to as sess the effect of added electrolyte and lipid phase quan tity on the admixture stability. METHODS Electrolytes were added to the studied admixture of a defined basic formulation contents in accordance with recommenda tions from the literature. Droplets size measurements were performed using the method of laser diffraction with a laser particles analyzer. Effects of independent variables were calculated and evaluated using commercial software. Na(+), K(+), Ca(2+) and Mg(2+) concentrations, as well as the quantity of fat phase were chosen as studied fac tors, i.e. independed variables. The system response, or dependent variable was the median of droplets size. Each of the factors was varied at two levels, higher (+1) and lower (-1), according to the 2(5-2) fractional factorial design. RESULTS The study suggested the presence of relative uni formity of the results of all the measurements regardless of the quantity of added electrolytes and lipid phase. It was shown that undoubtedly there is the influence of 2 valent cations (calcium and magnesium) upon lipid drop lets size, which is in a direct correlation with theoretical assumption. CONCLUSION Within a 72-hour testing period there was no significant increase in droplet size, i.e. the studied admixtures remained stable considering droplet size median as the criterion of stability.
منابع مشابه
Evaluation of physical stability of all in one parenteral admixtures for pediatric home care with high electrolytes concentrations.
INTRODUCTION The aim of the study was to evaluate stability of 48 total parenteral admixtures for pediatric patients who require home parenteral nutrition. Admixtures contain high amounts of electrolytes. In a clinical practice electrolytes-enrichment of the parenteral nutrition admixtures is a usual demand, especially on the neonatal/pediatric wards. The supplementation of parenteral nutrition...
متن کاملASHP Guidelines on the Safe Use of Automated Compounding Devices for the Preparation of Parenteral Nutrition Admixtures
Automated compounding devices are frequently used by pharmacists for the extemporaneous preparation of parenteral nutrition admixtures. This continuing shift from manual compounding procedures comes as a result of significant advances in automated technology, as well as in response to changing health care demands to provide admixture compounding in a safer, more efficient, and more accurate man...
متن کاملA.S.P.E.N. clinical guidelines: parenteral nutrition ordering, order review, compounding, labeling, and dispensing.
BACKGROUND Parenteral nutrition (PN) is a high-alert medication available for patient care within a complex clinical process. Beyond application of best practice recommendations to guide safe use and optimize clinical outcome, several issues are better addressed through evidence-based policies, procedures, and practices. This document provides evidence-based guidance for clinical practices invo...
متن کاملBacterial Contamination of Single- and Multiple-Dose Vials after Multiple Use and Intravenous Admixtures in Three Different Hospitals in Iran
There is possibility of microbial contamination of any single-dose vials (SDVs), multiple-dose vials (MDVs) and admixtures (ADXs) during the preparation and injection to the patients that could be resulted in bloodstream infection. The goal of this study was to investigate the microbial contamination of MDVs and SDVs after multiple use and ADXs prepared by nursing staff in the treatment room ve...
متن کاملApproach to Parenteral Nutrition
• To know the different systems for parenteral nutrition; their advantages and limits; • To know the risks associated with the compounding/ready-to-use preparation of AiO PN admixtures (GMP and potential incompatibility reactions) and the pharmacist’s tasks and responsibility for an admixing service; • To understand the general advice not to admix drugs to PN AiO admixtures, unless documented o...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Vojnosanitetski pregled
دوره 70 4 شماره
صفحات -
تاریخ انتشار 2013