[Neonatal parenteral nutrition formulation: where are we?]

Area of Science:

• Neonatal Medicine
• Clinical Pharmacy
• Nutritional Science

Background:

• Parenteral nutrition (PN) significantly improves outcomes for preterm infants.
• Recent years have seen increased publication of guidelines for PN in neonates.

Purpose of the Study:

• To investigate the formulation and preparation methods of neonatal parenteral nutrition (NPN) in Spanish hospitals.
• To identify current practices and variations in NPN preparation across different healthcare settings.

Main Methods:

• A multi-center survey was conducted among Pharmacy Services in Spanish hospitals.
• Data collection focused on NPN formulation, preparation procedures, and additive usage.

Main Results:

• Fifty-five hospitals participated, revealing diverse practices.
• Electronic prescribing used by 51%; 65.5% formulate individually, 34.4% use predesigned formulas.
• Significant variation exists in the use of tricameral preparations, phosphate addition, daily vitamin/trace element/zinc supplementation, and heparin use (50.9% never add).
• Photoprotected bags are widely used (89.1%), with stability ranging from 24 hours to 15 days.

Conclusions:

• The preparation of neonatal parenteral nutrition in Spain exhibits considerable variability.
• Controversies surrounding heparin use and ternary mixtures contribute to the observed diversity in clinical practice.