Compatibility and Stability of TPN Mixtures in Big Bags

Allwood, M.C.

doi:10.1111/j.1365-2710.1984.tb01076.x

Cited by 31 publications

(16 citation statements)

References 62 publications

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“…The existence of specific incompatibilities, such as the potential for precipitation of iron phosphate salts, has been recognized for many years [5]. Other examples have been reported which include copper incompatibility with particular amino acid solutions, possibly caused by the presence of cysteine [6], and the precipitation of elemental selenium in the presence of high ascorbic acid concentrations [7].…”

Section: Introductionmentioning

confidence: 99%

Assessment of trace element compatibility in total parenteral nutrition infusions

Allwood

Greenwood

1992

Pharmaceutisch Weekblad Scientific Edition

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The application of X-ray energy dispersive spectroscopy to detect elements collected from TPN mixtures on membrane filters has been investigated. Many simple total parenteral nutrition mixtures prepared aseptically in large bags can be stored for extended periods. Trace elements are normally excluded from such bags, because not enough is known about their long-term stability and compatibility in total parenteral nutrition mixtures. Assessing the compatibility of many trace elements by conventional methods that rely on detecting concentration changes is extremely difficult. Analysis of precipitates from total parenteral nutrition mixtures confirmed that the proposed method was capable of identifying a number of elements from the mixture in complex precipitates, including calcium, phosphorus, iron, copper and selenium.

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Section: Introductionmentioning

confidence: 99%

Assessment of trace element compatibility in total parenteral nutrition infusions

Allwood

Greenwood

1992

Pharmaceutisch Weekblad Scientific Edition

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“…The effect on the potency of the vitamins is not known, although ascorbic acid and thiamine are unstable in the presence of trace elements. 1 To overcome the formation of transition metal complexes duringTPN solution admixture, trace elements should be spaced well away from injections that can act as ligands, with adequate mixing after each addition. Aeration and prolonged storage should be avoided and where possible excess air in large bagTPN solutions should be removed during compounding.…”

Section: Discussionmentioning

confidence: 99%

“…Many variables, including temperature, pH, concentration, order of mixing, light exposure and aeration require careful attention to ensure that interactions are minimised. 1 In this study we examined the precipitation of calcium oxalate in Fotios Trace Elements Solution (TES, David Bull Laboratories) is routinely added toTPN solutions atThe Queen Elizabeth Hospital in order to prevent deficiency states in patients undergoing prolonged parenteral hyperalimentation. 2 ' 3 Ambados has reported an incompatibility between aminophylline and elemental zinc injections during parenteral nutrition admixture.…”

Section: Introductionmentioning

confidence: 99%

Incompatibilities with Trace Elements During TPN Solution Admixture

Ambados

Brealey

1998

The Australian Journal of Hospital Pharmacy

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Objective: To demonstrate both physical and chemical incompatibilities noted between Trace Elements Solution (TES) and various injections during total parenteral nutrition (TPN) solution admixture. Method: Incompatibilities were reproduced by two methods: 1. drawing up the suspect injection into a Luer-lok syringe followed by 5 mL ofTES, or 2. mixing additives in situ and transferring the injection solution into Luer-lok syringes, as in our investigation of calcium oxalate precipitation.Using syringes allowed easy visual inspection for the presence of haze, precipitate, and colour change. Electron microscopy was also used but only when a suspected precipitate was not grossly visible. Where possible the nature of the incompatibility was determined. Results: Definite incompatibilities were observed between TES and the injections that were tested. Conclusion: Trace elements do have the potential to interact with other additives in TPN solution, either via catalytic effects or the ability to form transition metal complexes. Their presence can affect both the stability and compatibility of various organic compound-containing injections.

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“…The stability, however, is compromised by formulating 'All in One' regimens (Black and Popovich, 1981;Pamper! and Kleinberger, 1982;Burnham et al, 1983;Allwood, 1984;Whateley et al, 1984;Davis et al, 1985;Davis and Galloway, 1986;Driscoll et al, 1986). Preparations of 'All in One' regimens involve the admixture of emulsions, amino-acids, trace elements and vitamins resulting in a single infusion that satisfies most, or all, of the nutritional requirements of the patient.…”

Section: Introductionmentioning

confidence: 99%

An interfacial equilibria model for the electrokinetic properties of a fat emulsion. Part II: Magnesium, zinc and proton interactions with the interface

Gaskin

Hall

Williams

1993

Chemical Speciation & Bioavailability

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The semi-empirical thermodynamic model reported in an earlier paper (Hallet a/., 1991) is further developed to describe the zeta potential behaviour of an intravenous fat emulsion in the presence of magnesium and zinc cations. The effect of interfacial protonation is also explored. We have now established that a previously reported formation constant for the calcium interaction is actually a conditional value and together with the new data for zinc and magnesium, overall formation constants are calculated.

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Compatibility and Stability of TPN Mixtures in Big Bags

Cited by 31 publications

References 62 publications

Assessment of trace element compatibility in total parenteral nutrition infusions

Assessment of trace element compatibility in total parenteral nutrition infusions

Incompatibilities with Trace Elements During TPN Solution Admixture

An interfacial equilibria model for the electrokinetic properties of a fat emulsion. Part II: Magnesium, zinc and proton interactions with the interface

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