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Lipid destabilisation in a ternary admixture for paediatric parenteral nutrition due to heparin and trigger factors

C Hernández Prats1, M Real Panisello, M J Fuentes Bonmatí

  • 1FEA, Servicio de Farmacia, Hospital General de Elda, Alicante, España. hernandez carpra@gva.es

Farmacia Hospitalaria : Organo Oficial De Expresion Cientifica De La Sociedad Espanola De Farmacia Hospitalaria
|April 14, 2012
PubMed

Insights

Paediatric parenteral nutrition (PN) admixtures lack standardized preparation, risking patient safety. This study details a case of creaming in a ternary PN admixture, identifying causes and preventative measures for improved stability.

Area of Science:

  • Clinical Pharmacy
  • Nutritional Science
  • Pharmaceutical Compounding

Background:

  • Preparation of paediatric parenteral nutrition (PN) admixtures lacks consensus on critical components like phosphate/calcium salts, lipid types, and additives (heparin, carnitine).
  • Standardization is crucial for PN admixture stability, yet precise prediction methods, especially for ternary mixtures, are unavailable.
  • Variability in preparation can lead to destabilization, posing risks to patient safety.

Observation:

  • A case of creaming, a form of lipid phase separation, was observed in a ternary paediatric PN admixture.
  • Creaming indicates a critical instability within the PN formulation.
  • This phenomenon highlights the challenges in ensuring the physical stability of complex PN admixtures.

Findings:

  • Specific factors contributing to the observed creaming in the ternary PN admixture were identified.
  • The study elucidates the physicochemical interactions leading to destabilization in this specific formulation.
  • Understanding these factors is key to preventing future occurrences.

Implications:

  • The findings underscore the need for improved standardization in paediatric PN admixture preparation.
  • Developing reliable methods to predict PN admixture stability is essential for clinical practice.
  • Implementing the identified measures can enhance the safety and efficacy of paediatric parenteral nutrition.

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