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ASPEN lipid injectable emulsion safety recommendations part 2: Neonate and pediatric considerations
M Petrea Cober1,2, Kathleen M Gura3,4,5, Jay M Mirtallo6,7
1Neonatal Intensive Care Unit, Akron Children's Hospital, Akron, Ohio, USA.
Summary
Lipid injectable emulsions (ILEs) require specific safety protocols for neonatal and pediatric patients, differing from adult care. Adhering to best practices minimizes adverse events and ensures safe parenteral nutrition (PN) therapy.
Area of Science:
- Pharmaceutical Sciences
- Pediatric Nutrition
- Clinical Pharmacy
Background:
- Lipid injectable emulsions (ILEs) are vital for parenteral nutrition (PN), providing energy and fatty acids.
- Neonatal and pediatric patients have unique physiological needs and higher dosage requirements for ILEs compared to adults.
- ILEs are frequently implicated in PN errors, particularly in administration, prescribing, and transcription processes.
Purpose of the Study:
- To address the specific safety considerations for using ILEs in neonatal and pediatric patients.
- To highlight differences in ILE use between pediatric and adult populations.
- To provide a comprehensive overview of safe ILE practices for pediatric PN therapy.
Main Methods:
- Review of current literature and clinical guidelines on ILE use in pediatric populations.
- Analysis of PN errors associated with ILEs in neonatal and pediatric patients.
- Description of safe-use considerations based on ILE product information in the United States.
Main Results:
- ILE use in neonates and pediatrics necessitates distinct protocols due to higher dosage needs and administration challenges.
- Adverse effects are often linked to exceeding recommended ILE dosages.
- Gaps in best practices contribute to errors in the PN system for pediatric patients.
Conclusions:
- Safe and effective use of ILEs in neonatal and pediatric patients requires tailored guidelines.
- Addressing prescribing, preparation, administration, and monitoring is crucial for minimizing risks.
- Adherence to manufacturer recommendations and established best practices is essential for optimal pediatric PN outcomes.
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