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Maximizing calcium and phosphate content in neonatal parenteral nutrition solutions using organic calcium and

Lucie Bouchoud1, Caroline Fonzo-Christe, Farshid Sadeghipour

  • 1Pharmacy, Geneva University Hospitals, Geneva, Switzerland. lucie.bouchoud@hcuge.ch

JPEN. Journal of Parenteral and Enteral Nutrition
|September 21, 2010
PubMed

Insights

Using organic calcium and phosphate salts in parenteral nutrition (PN) significantly reduces calcium phosphate precipitation risk. This allows for higher safe concentrations, meeting neonatal nutritional needs.

Area of Science:

  • Neonatal nutrition
  • Parenteral nutrition
  • Biochemistry

Background:

  • Adequate calcium and phosphate are crucial for neonatal bone development via parenteral nutrition (PN).
  • Calcium phosphate precipitation in PN limits electrolyte concentrations to 5 mmol/L due to incompatibility issues with inorganic salts.
  • Investigating alternatives to inorganic salts is essential for optimizing PN formulations.

Purpose of the Study:

  • To evaluate the precipitation risk of calcium phosphate using organic salts compared to inorganic salts in PN solutions.
  • To determine if organic calcium and phosphate salts can enable higher safe concentrations in PN.

Main Methods:

  • Precipitation curves were generated for both inorganic and organic calcium and phosphate salts.
  • Testing was conducted in a PN solution designed to promote precipitation (low amino acid and glucose concentrations).
  • Precipitation was assessed using visual inspection and particle count analysis.

Main Results:

  • Organic phosphate salts markedly reduced the risk of calcium phosphate precipitation.
  • No precipitation was observed with organic salts up to 50 mmol/L of calcium and phosphate.
  • Organic calcium salts offered only a marginal decrease in precipitation risk.

Conclusions:

  • Parenteral nutrition solutions can safely incorporate up to 50 mmol/L of organic calcium and phosphate salts, even under challenging conditions.
  • This advancement facilitates adherence to European recommendations for neonatal nutrient requirements.
  • The use of organic salts represents a significant improvement in PN formulation safety and efficacy for neonates.
Abstract

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