scholarly journals Standardised neonatal parenteral nutrition formulations – Australasian Neonatal Parenteral Nutrition Consensus update 2017

2020 ◽  
Author(s):  
Srinivas Bolisetty ◽  
David Osborn ◽  
Tim Schindler ◽  
John Sinn ◽  
Girish Deshpande ◽  
...  
Keyword(s):  
Systematic Review ◽  
Amino Acid ◽  
Parenteral Nutrition ◽  
Nutrient Intake ◽  
Inorganic Phosphate ◽  
Organic Phosphate ◽  
Evidence Based ◽  
Lipid Emulsions ◽  
Phosphate Content ◽  
Baxter Healthcare

Abstract Background: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines. Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed. Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed. Conclusions: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.

scholarly journals Standardised neonatal parenteral nutrition formulations – Australasian Neonatal Parenteral Nutrition Consensus update 2017

2020 ◽  
Author(s):  
Srinivas Bolisetty ◽  
David Osborn ◽  
Tim Schindler ◽  
John Sinn ◽  
Girish Deshpande ◽  
...  
Keyword(s):  
Systematic Review ◽  
Amino Acid ◽  
Parenteral Nutrition ◽  
Nutrient Intake ◽  
Inorganic Phosphate ◽  
Organic Phosphate ◽  
Evidence Based ◽  
Lipid Emulsions ◽  
Phosphate Content ◽  
Baxter Healthcare

Abstract Background: The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines. Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed. Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid (Fresenius Kabi, Australia) and ClinOleic (Baxter Healthcare, Australia) preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed. Conclusions: The 2017 PN formulations and guidelines developed by the 2017 Neonatal Parenteral Nutrition Consensus Group offer concise and practical instructions to clinicians on how to implement current and up-to-date evidence based PN to the NICU population.

scholarly journals Standardised neonatal parenteral nutrition formulations – Australasian Neonatal Parenteral Nutrition Consensus update 2017

2019 ◽  
Author(s):  
Srinivas Bolisetty ◽  
David Osborn ◽  
Tim Schindler ◽  
John Sinn ◽  
Girish Deshpande ◽  
...  
Keyword(s):  
Amino Acid ◽  
Parenteral Nutrition ◽  
Nutrient Intake ◽  
Inorganic Phosphate ◽  
Cost Savings ◽  
Organic Phosphate ◽  
Lipid Emulsions ◽  
Phosphate Content ◽  
Australasian Region ◽  
Nutrition Practice

Abstract The first consensus standardised neonatal parenteral nutrition formulations were implemented in many neonatal units in Australia in 2012. The current update involving 49 units from Australia, New Zealand, Singapore, Malaysia and India was conducted between September 2015 and December 2017 with the aim to review and update the 2012 formulations and guidelines. Methods: A systematic review of available evidence for each parenteral nutrient was undertaken and new standardised formulations and guidelines were developed. Results: Five existing preterm Amino acid-Dextrose formulations have been modified and two new concentrated Amino acid-Dextrose formulations added to optimise amino acid and nutrient intake according to gestation. Organic phosphate has replaced inorganic phosphate allowing for an increase in calcium and phosphate content, and acetate reduced. Lipid emulsions are unchanged, with both SMOFlipid and ClinOleic preparations included. The physicochemical compatibility and stability of all formulations have been tested and confirmed. Guidelines to standardise the parenteral nutrition clinical practice across facilities have also been developed. Conclusions: Formulations and guidelines to standardise parenteral nutrition practice across the Australasian region have the potential to improve nutrition and clinical outcomes of neonates. Standardisation can also result in cost savings, quality improvement and error minimisation in PN prescribing and ordering.

scholarly journals Compatibility of Maximum Inorganic and Organic Calcium and Phosphate Content in Neonatal Parenteral Solutions

2018 ◽  
Author(s):  
Dorota Watrobska-Swietlikowska
Keyword(s):  
Amino Acid ◽  
Parenteral Nutrition ◽  
Membrane Filter ◽  
Organic Phosphate ◽  
Phosphate Content ◽  
Solution Ph ◽  
Organic Salts ◽  
Black And White ◽  
Safe Concentration ◽  
Inorganic And Organic

The aim of the study was to determine the maximum safe concentration of calcium and phosphate in neonatal parenteral nutrition (PN) solutions when various combinations of inorganic and organic salts are applied. Twelve PN solutions for neonatal use were aseptically prepared. Increasing concentration of inorganic and organic calcium and phosphate were added to the standard formulas. Each admixture was separately tested according to following conditions; after mixing, 37°C for 24 h, and maximum safe combination of calcium and phosphate were stored at 4°C for 30 days and followed by 24 h at 37°C. Visual inspections against a black and white contrast background, microscopic observation of undiluted PN solutions as well as the membrane filter after filtration of the PN solution, pH evaluation, and spectrophotometry at 600 nm were examined in triplicate. Safe maximum concentration of organic and inorganic calcium and phosphate was proposed individually for each composition of parenteral nutrition solutions. Surprisingly organic calcium with organic phosphate showed precipitation but over the therapeutic range. The protective effect of amino acid was observed and higher concentrations of calcium and phosphate were free of precipitation.

scholarly journals Fish oil- and soy oil-based lipid emulsions in neonatal parenteral nutrition: a systematic review and meta-analysis

2016 ◽  
Vol 70 (10) ◽  
pp. 1106-1115 ◽  
Author(s):  
P Kotiya ◽  
X Zhao ◽  
P Cheng ◽  
X Zhu ◽  
Z Xiao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Parenteral Nutrition ◽  
Fish Oil ◽  
Meta Analysis ◽  
Soy Oil ◽  
Lipid Emulsions

scholarly journals O futuro da nutrição parenteral no paciente crítico

2020 ◽  
Vol 2 (35) ◽  
pp. 187-192
Author(s):  
Ivens Augusto Oliveira de Souza
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critical Illness ◽  
Parenteral Nutrition ◽  
Indirect Calorimetry ◽  
Critically Ill Patients ◽  
Nutrient Intake ◽  
Lipid Emulsions ◽  
Gastrointestinal Dysfunction ◽  
Best Value

Gastrointestinal dysfunction and inadequate nutrient intake are frequently seen in critically ill patients. Recent studies have shown that parenteral nutrition is safe among these patients. This narrative review aims to describe the risks associated with overfeeding and how to safely indicate and implement parenteral nutrition in the intensive care unit. After the acute phase of critical illness, individualized parenteral nutrition, using indirect calorimetry and balanced lipid emulsions, may be associated with better outcomes. The demand for ready-to-use bags has been growing intended to achieve the best value of care for patients and healthcare institutions.

Aluminum contamination of parenteral nutrition additives, amino acid solutions, and lipid emulsions

Nutrition ◽  
1999 ◽  
Vol 15 (9) ◽  
pp. 683-686 ◽  
Author(s):  
Katarzyna Popińska ◽  
Jaroslaw Kierkuś ◽  
Malgorzata Lyszkowska ◽  
Jerzy Socha ◽  
Ewa Pietraszek ◽  
...  
Keyword(s):  
Amino Acid ◽  
Parenteral Nutrition ◽  
Lipid Emulsions ◽  
Acid Solutions ◽  
Amino Acid Solutions

scholarly journals Bovine pepsinogens and pepsins. A series of zymogens and enzymes that differ in organic phosphate content

1971 ◽  
Vol 121 (2) ◽  
pp. 249-256 ◽  
Author(s):  
Patricia A. Meitner ◽  
Beatrice Kassell
Keyword(s):  
Acid Phosphatase ◽  
Amino Acid ◽  
Amino Acid Composition ◽  
Acid Composition ◽  
Chromatographic Separation ◽  
Organic Phosphate ◽  
Phosphate Content ◽  
Fundic Mucosa ◽  
High Phosphate

Several minor pepsinogens, present in extracts of bovine fundic mucosa obtained from the fourth stomach or abomasum, were separated from the main pepsinogen by chromatography on hydroxyapatite at pH7.3. The major pepsinogen and two of these minor pepsinogens were studied in detail. All three zymogens have N-terminal Ser-Val-, C-terminal -Val-Ala and not more than 1mol of glucose/mol of protein; no significant differences in amino acid composition were found. The pepsinogens differ in their organic phosphate content, which accounts for their chromatographic separation. By activation at 0°C and pH2, a corresponding series of pepsins is formed. These enzymes were separated by hydroxyapatite chromatography at pH5.7. All the pepsins have N-terminal valine, C-terminal alanine and are free from carbohydrate. Again the only difference detected among them is in their organic phosphate content. The pepsins of high phosphate content are converted by an acid phosphatase in vitro into pepsins of low phosphate content.

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