OHP-021 Development and Implementation of a Peripheral Standard Parenteral Nutrition For a Neonatology Department

Abstract

Background Parenteral nutrition (PN) for neonates has to be infused by a central line, due to the high osmolarity resulting from the recommended requirements. The central catheter frequently needs to be removed, and therefore PN may have to be administered by a peripheral line. This problem has been resolved by infusion of enriched glucose solutions, minus the protein input, which is very important in order to avoid catabolism. Purpose To develop a standard PN with glucose, electrolytes and amino acids, suitable for peripheral infusion and available for the Neonatology department at any time. The aim is to infuse 100 mL/Kg. Materials and MethodsWe performed a literature search about standard PN and we made microbiological and biochemical cheques to ensure the stability and integrity of the solution, after keeping it refrigerated for seven days. ResultsWe developed a standard PN solution with the following composition per 100 mL: Amino acids: 2 g Glucose: 9.5 g Sodium: 4 mEq Potassium: 2 mEq Magnesium: 0.2 mEq Calcium: 1.5 mEq Phosphate: 0.8 mmol Osmolarity: 792 mOsm/L Total calories: 46 Kcal Weekly, we prepare four 500 ml bags from a stock solution. We give the neonatology department two so they can hold a small stock and we keep the other two in order to cheque when we need to make another batch. From implementation, in February 2012, the microbiological controls have always been negative and the biochemical controls have demonstrated that degradation does not occur after refrigeration for seven days. Conclusions This formulation makes it possible for the physicians to continue with the nutritional support, by peripheral infusion, at any time. However this type of nutritional solutions is only suitable for meeting the nutritional requirements for short periods, until a new central catheter is placed or the neonate is able to have complete enteral feeding. No conflict of interest.