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Pharmacist-Led Assessment of Y-Site Compatibility in Pediatric Total Parenteral Nutrition: A Prospective Study of

Beatriz Leal Pino1, Belén Riva de la Hoz1, Marta Echávarri de Miguel1

  • 1PharmD, is with the Pharmacy Service, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

The Canadian Journal of Hospital Pharmacy
|May 11, 2026
PubMed

Insights

Hospital pharmacists play a crucial role in ensuring safe total parenteral nutrition (TPN) administration for pediatric patients. A study found many drug-TPN combinations lacked compatibility data, underscoring the need for further research.

Area of Science:

  • Pharmaceutical Sciences
  • Pediatric Medicine
  • Clinical Pharmacy

Background:

  • Total parenteral nutrition (TPN) is a complex, high-alert medication requiring careful administration by hospital pharmacists.
  • Y-site incompatibilities during TPN administration can lead to serious adverse events like embolism or thrombosis.
  • Pediatric patients are particularly vulnerable to TPN-related errors due to complex formulations and limited venous access.

Purpose of the Study:

  • To define the role of pharmaceutical care in managing Y-site drug administration with TPN in pediatric patients.
  • To implement and evaluate a systematic approach for assessing TPN-drug compatibility in pediatric care.

Main Methods:

  • A prospective observational study was conducted at a university children's hospital.
  • Clinical pharmacists systematically evaluated the compatibility of intravenous drugs with TPN using an evidence-based approach.
  • TPN-drug combinations were classified, and recommendations were documented in electronic health records.

Main Results:

  • Of 40 TPN episodes in 37 pediatric patients, pharmacists performed 604 interventions.
  • Over 40% of reviewed drug-TPN combinations had unknown or contradictory compatibility information.
  • 16.6% of Y-site drug-TPN combinations were identified as incompatible.

Conclusions:

  • Pharmacist-led Y-site compatibility assessment is vital for pediatric TPN safety and patient outcomes.
  • A significant proportion of drugs lack sufficient data regarding TPN compatibility, necessitating further investigation.
  • Enhanced research is crucial for informed clinical decision-making in pediatric TPN management.
Abstract

Keywords:
Mots-clés: nutrition parentéraleY-site compatibilitycompatibilité en Yhemato-oncologyhémato-oncologieinnocuité des médicamentsmedication safetyparenteral nutritionpediatricspharmaceutical carepédiatriesoins pharmaceutiques

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