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Published on: September 20, 2019
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Premixed Parenteral Nutrition Solution Use in Children.
Rebecca F Chhim1, Catherine M Crill2
1Department of Clinical Pharmacy, The University of Tennessee Health Science Center, Memphis, Tennessee ; Le Bonheur Children's Hospital, Memphis, Tennessee.
Summary
Commercial premixed parenteral nutrition (PN) solutions can support pediatric patients during drug shortages. Close monitoring of electrolytes, protein, and calories is recommended due to potential laboratory abnormalities.
Area of Science:
- Pediatric Nutrition
- Parenteral Nutrition Therapy
- Clinical Pharmacy Practice
Background:
- National drug shortages prompted the use of commercial premixed parenteral nutrition (PN) solutions in pediatric patients.
- Existing data on premixed PN solutions in pediatric populations are limited.
- Institutional criteria were developed for the appropriate use of these solutions.
Purpose of the Study:
- To review the utilization and outcomes of commercial premixed PN solutions in pediatric patients.
- To assess the safety and efficacy of premixed PN in this specific patient group.
Main Methods:
- Retrospective review of pediatric patients (≤18 years) who received premixed PN.
- Assessment of premixed PN discontinuation rates due to laboratory abnormalities.
- Evaluation of protein and caloric intake for courses lasting >48 hours.
Main Results:
- 74 courses of premixed PN were administered to 69 pediatric patients.
- 20% of courses were discontinued due to mild laboratory abnormalities, which resolved upon switching to individualized PN.
- Premixed PN provided goal protein in 98% and goal calories in 67% of courses lasting over 48 hours.
Conclusions:
- Commercial premixed PN solutions offer a viable option for pediatric patients during PN product shortages.
- Close monitoring for electrolyte disturbances and nutritional adequacy is crucial when using premixed PN in children.
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