Article Data

  • Views 1404
  • Dowloads 121

Reviews

Open Access

Safe parenteral nutrition and the role of standardised feeds

  • JOHN PUNTIS1

1,The General Infirmary at Leeds Great George Street

DOI: 10.22514/SV51.042010.1 Vol.5,Issue 1,April 2010 pp.8-12

Published: 27 April 2010

*Corresponding Author(s): JOHN PUNTIS E-mail: john.puntis@leedsth.nhs.uk

Abstract

Workload pressure on pharmacies through increased demands for parenteral nutrition (PN) is leading to a growing trend in the use of commercially manufactured PN (‘standard feeds’) and away from individually ‘tailored’ prescriptions. This is sometimes justified on grounds of safety, although many areas of risk remain inherent in the process of PN provision. In fact there is little to suggest that widespread introduction of standard feeds would do much to further reduce the already low frequency of serious adverse events. The relative clinical benefits of providing standard feeds or tailored feeds have not been adequately studied, making it impossible to give a clear endorsement of one system over the other. It seems probable that for a proportion of stable patients a range of standard feeds could provide adequate nutritional support, while in unsta-ble patients with complex needs and those needing long term PN, tailored feeds appear the more logical choice. Pharmacy compounding units, therefore, need to remain flexible in their approach to PN provision. Since even small variations in nutrient intake in early life may have long lasting implications for extremely premature infants the processes of formulating and providing PN deserve further study.

Keywords

parenteral nutrition, stan-dard feeds, pre-mixed PN solution, tailored feeds, premature infants

Cite and Share

JOHN PUNTIS. Safe parenteral nutrition and the role of standardised feeds. Signa Vitae. 2010. 5(1);8-12.

References

01. Wilmore DM, Dudrick SJ. Growth and development of an infant receiving all nutrients by vein. JAMA 1968;203:860-4.

02. Puntis JWL. Nutritional support in neonatology. In: Sobotka L, editor. Basics in Clinical Nutrition. 3rd ed. Prague: Galen; 2004. p. 425-39.

03. Oliva PB. Lactic acidosis. Am J Med 1970;48:209-25.

04. Johnson JD, Albritton WL, Sunshine P. Hyperammonaemia accompanying parenteral nutrition in newborn infants. J Pediatr 1972;81:154-61.

05. Hodge D, Puntis JWL. Diagnosis, prevention, and management of catheter related blood stream infection during long term parenteral nutrition. Arch Dis Child Fetal Neonatal Ed 2002;87:21-4.

06. Kelly DA. Intestinal failure associated liver disease – what do we know today? Gastroenterology 2006;130:S70-7.

07. Peters M, Beath SV, Puntis JWL, John P. Superior vena cava thrombosis causing respiratory obstruction successfully resolved by stenting in a small bowel transplantation candidate. Arch Dis Child 2000;83:163-4.

08. Agostoni C, Axelsson I, Colomb V, Goulet O, Koletzko B, Michaelsen KF, Puntis JWL, Rigo J, Shamir R, Szajewska H, Turck D. The need for nutrition support teams in paediatric units: a commentary by the ESPGHAN Committee on Nutrition. JPGN 2005;41:8-11.

09. Organisational aspects of hospital PN. In: Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R, editors. Guidelines on paediatric parenteral nutrition of ESPGHAN, ESPEN, and supported by the ESPR. J Pediatr Gastroent Nutr 2005;41:63-9.

10. Kuiper SA, McCreadie SR, Mitchell JF, Stevenson JG. Medication errors in inpatient pharmacy operations and technologies for improve-ment. Am J Health System Pharm 2007;64:955-959.

11. Shah J. Automated dispensing of parenteral nutrition formulations. Hosp Pharm 2003;10:63-5.

12. Bonnabry P, Cingria L, Sadeghipour F, Ing H, Fonzo-Christe C, Pfister RE. Use of a systemic risk analysis method to improve safety in production of paediatric parenteral nutrition solutions. Qual Saf Health Care 2005;14:93-8.

13. Sacks GS, Rough S, Kudsk KA. Frequency and severity of harm of medication errors related to the parenteral nutrition process in a large university teaching hospital. Pharmacotherapy 2009;29:966-74.

14. Ball PA, Candy DCA, Puntis JWL, McNeish AS. Portable bedside microcomputer system for management of parenteral nutrition in all age groups. Arch Dis Child 1985;60:435-9.

15. Cade A, Thorp H, Puntis JWL. Does the computer improve the nutritional support of the newborn? Clin Nutr 1997;16:19-23.

16. Beecroft C, Martin H, Puntis JWL. How often do parenteral nutrition prescriptions for the newborn need to be individualised? Clin Nutr1999;18:83-5.

17. Yeung MY, Smyth JP, Maheshwari R, Shah S. Evaluation of standardised versus individualized total parenteral nutrition regime for neonates less than 33 weeks gestation. J Pediatr Child Health 2003;39:613-7.

18. Lenclen R, Crauste-Manciet S, Narcy P, Boukhouna S, Geffray A, Guerrault M-N, Bordet F, Brossard D. Assessment of implementation of a standardized parenteral formulation for early nutritional support of very preterm infants. Eur J Pediatr 2006;165:512-8.

19. Krohn K, Babl J, Reiter K, Koletzko B. Parenteral nutrition with standard solutions in paediatric intensive care patients. Clin Nutr 2005;24:274-80.

20. Eleni-dit-Trolli S, Kermovant-Duchemin E, Huon C, Mokthari M, Husseini K, Brunet M-L, Dupont C, Lapillonne A. Early individualised par-enteral nutrition for preterm infants. Arch Dis Child Fetal Neonatal Ed 2009;94:152-3.

21. Brandt I, Sticker EJ, Lentze MJ. Catch-up growth and head circumference of very low birthweight, small for gestational age preterm infants and mental development to adulthood. J Pediatr 2003;142:463-8.

22. Lucas A, Morley R, Cole TJ. Randomised trial of early diet in preterm babies and later intelligence quotient. Brit Med J 1998;317:1481-7.

23. Miller SJ. Commercial premixed parenteral nutrition: is it right for your institution? Nutr Clin Pract 2009;24:459-69.

24. Diorio LS, Thomas DL. Premix vs. custom TPN technical paper. Englewood: Baxa Corporation [serial online] 2007 [cited 2010 Jan 20]; Available from: http://www.baxa.com/resources/docs/pressreleases/Premix%20TPN%20Technical%20Paper.pdf

Abstracted / indexed in

Science Citation Index Expanded (SciSearch) Created as SCI in 1964, Science Citation Index Expanded now indexes over 9,200 of the world’s most impactful journals across 178 scientific disciplines. More than 53 million records and 1.18 billion cited references date back from 1900 to present.

Journal Citation Reports/Science Edition Journal Citation Reports/Science Edition aims to evaluate a journal’s value from multiple perspectives including the journal impact factor, descriptive data about a journal’s open access content as well as contributing authors, and provide readers a transparent and publisher-neutral data & statistics information about the journal.

Chemical Abstracts Service Source Index The CAS Source Index (CASSI) Search Tool is an online resource that can quickly identify or confirm journal titles and abbreviations for publications indexed by CAS since 1907, including serial and non-serial scientific and technical publications.

Index Copernicus The Index Copernicus International (ICI) Journals database’s is an international indexation database of scientific journals. It covered international scientific journals which divided into general information, contents of individual issues, detailed bibliography (references) sections for every publication, as well as full texts of publications in the form of attached files (optional). For now, there are more than 58,000 scientific journals registered at ICI.

Geneva Foundation for Medical Education and Research The Geneva Foundation for Medical Education and Research (GFMER) is a non-profit organization established in 2002 and it works in close collaboration with the World Health Organization (WHO). The overall objectives of the Foundation are to promote and develop health education and research programs.

Scopus: CiteScore 1.0 (2022) Scopus is Elsevier's abstract and citation database launched in 2004. Scopus covers nearly 36,377 titles (22,794 active titles and 13,583 Inactive titles) from approximately 11,678 publishers, of which 34,346 are peer-reviewed journals in top-level subject fields: life sciences, social sciences, physical sciences and health sciences.

Embase Embase (often styled EMBASE for Excerpta Medica dataBASE), produced by Elsevier, is a biomedical and pharmacological database of published literature designed to support information managers and pharmacovigilance in complying with the regulatory requirements of a licensed drug.

Submission Turnaround Time

Conferences

Top