Related Experiment Videos
Product availability for pediatric parenteral nutrition
1Pushpawati Singhania Research Institute For Liver, Renal and Digestive Diseases (PSRI), Saket, New Delhi.
Insights
Parenteral nutrition (PN) in India is hindered by the lack of readily available pediatric-sized products. Custom mixing of PN solutions may be a cost-effective alternative for children, provided calorie content is carefully managed to prevent metabolic issues.
Area of Science:
- Nutritional Support
- Pediatric Medicine
- Healthcare Economics
Background:
- Parenteral nutrition (PN) is crucial for pediatric patients, especially in developing nations like India.
- The cost-effectiveness of PN for children is often compromised by the limited availability of pediatric-specific formulations.
- Current adult PN products are not ideal for pediatric use due to volume and cost considerations.
Purpose of the Study:
- To evaluate the availability and cost-effectiveness of parenteral nutrition products in the Indian market for pediatric use.
- To explore alternative strategies for providing parenteral nutrition to children in India.
Main Methods:
- Review of currently available parenteral nutrition products in India.
- Analysis of cost-effectiveness of adult versus pediatric PN formulations.
- Discussion of the pros and cons of PN solution mixing for pediatric patients.
Main Results:
- Small-capacity (100 ml) all-in-one PN bags suitable for pediatric use are not readily available in India.
- Adult PN bags, while available, are not cost-effective for pediatric patients.
- Opinions on PN mixing are divided; concerns exist regarding potential metabolic derangements from high concentrations.
Conclusions:
- The lack of accessible pediatric PN products presents a significant challenge in India.
- Mixing PN solutions tailored to pediatric needs might be an ideal solution for India, balancing cost-effectiveness and safety.
- Careful control of calorie content in mixed PN solutions is essential to prevent adverse metabolic effects in children.
Abstract:
Availability of parenteral nutrition (PN) products for use in pediatric patients is an important factor for popularity of PN in developing countries like India. The overall cost of PN supplementation in the adult patient works out to be approximately Rs. 2000 per day. It should be more cost effective in a child, working out to Rs. 750 per day on an average. However, it is not so because smaller bags of 100 ml capacity designed for pediatric use are not so readily available. The article provides detailed information regarding presently available PN products in Indian markets. All-in-one PN bags of 100 ml capacity (containing amino acids, lipids and dextrose), designed for use in adult patients, would not be cost effective for use in children. Opinions regarding PN mixing are divided and most of the practitioners in the developed countries do not favour mixing because higher concentrations of lipids and dextrose in the solution can cause metabolic derangements in the patients. In view of the problems related to availability of PN products, mixing PN solution may be ideal for India, if calorie content of the infusate is kept at a level just enough to sustain life but not high enough to cause metabolic disturbances.