Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review

Alfonso, Jorge Emilio; Berlana, David; Ukleja, Andrew; Boullata, Joseph I.

doi:10.1177/0148607116657541

Cited by 25 publications

(35 citation statements)

References 47 publications

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“…Lipid emulsions can be given separately or as part of a total nutrient admixture. Total nutrient admixtures (including commercial multi‐chamber bags and pharmacy compounded bags) reduce line manipulations, infection risk, and cost compared with multi‐bottle systems . In addition, commercial multi‐chamber PN products are associated with fewer medication errors .…”

Section: Practical Handling Aspectsmentioning

confidence: 99%

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Martindale

Berlana

Boullata

et al. 2020

J Parenter Enteral Nutr

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Background The 2018 Lipids in Parenteral Nutrition summit involved a panel of experts in clinical nutrition, lipid metabolism, and pharmacology, to assess the current state of knowledge and develop expert consensus statements regarding the use of intravenous lipid emulsions in various patient populations and clinical settings. The main purpose of the consensus statements is to assist healthcare professionals by providing practical guidance on common clinical questions related to the provision of lipid emulsions as part of parenteral nutrition (PN). Methods The summit was designed to allow interactive discussion and consensus development. The resulting consensus statements represent the collective opinion of the members of the expert panel, which was informed and supported by scientific evidence and clinical experience. Results The current article summarizes the key discussion topics from the summit and provides a set of consensus statements designed to complement existing evidence‐based guidelines. Lipid emulsions are a major component of PN, serving as a condensed source of energy and essential fatty acids. In addition, lipids modulate a variety of biologic functions, including inflammatory and immune responses, coagulation, and cell signaling. A growing body of evidence suggests that lipid emulsions containing ω‐3 fatty acids from fish oil confer important clinical benefits via suppression of inflammatory mediators and activation of pathways involved in the resolution of inflammation. Conclusions This article provides a set of expert consensus statements to complement formal PN guideline recommendations.

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Section: Practical Handling Aspectsmentioning

confidence: 99%

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Martindale

Berlana

Boullata

et al. 2020

J Parenter Enteral Nutr

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“…State boards of pharmacy or other comparable professional regulatory bodies should hold accountable those who prepare PN admixtures, as this takes place in the pharmacy. Although multi‐bottle or 2‐in‐1 PN systems are used when stability concerns exist, TNA (whether commercial MCBs or custom compounded) reduces manipulations and resultant risk of infection and lowers costs compared with multi‐bottle PN systems . Among other advantages, commercial MCB products are also associated with fewer errors …”

Section: Ile Preparationmentioning

confidence: 99%

“…In the past, the potential disadvantage of using MCBs was the limited range of formulae available, but there are currently a large variety of standard MCBs on the market, except in some countries such as the United States. MCBs have certain advantages over hospital‐compounded PN such as a longer shelf life, manufacturer‐guaranteed stability, easy traceability, and clinical advantages mentioned previously . Moreover, standardization with MCBs appears to offer significant cost savings and reduced preparation time over compounding, as well as a reduction in errors related to PN preparation …”

Section: Standardization Of Pnmentioning

confidence: 99%

Use of Intravenous Lipid Emulsions With Parenteral Nutrition: Practical Handling Aspects

Boullata

Berlana

Piętka³

et al. 2020

J Parenter Enteral Nutr

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A number of topics important to the handling of intravenous lipid emulsions (ILEs) were discussed at the international summit. ILE handling includes the preparation and the administration steps in the typical use of parenteral nutrition (PN). The discussion and consensus statements addressed several issues, including standardization of the PN process, use of commercially available multi‐chamber PN or compounded PN bags, the supervision by a pharmacist with expertise, limiting ILE repackaging, and infusion duration.

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“…MCBs contain macronutrients with or without electrolytes in separate compartments within the same bag. The various PN components are mixed by breaking a plastic seal, and vitamins, electrolytes, and trace elements can be added to the bag just prior to administration for further individualization if necessary 37 . This separation of the various PN components provides the MCBs a significantly longer shelf‐life of 12–24 months at room temperature 37 .…”

Section: Lipid Deliverymentioning

confidence: 99%

Home Parenteral Nutrition

2016

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Since the first intravenous nutrition support attempt with olive oil in the 17th century, intravenous fat emulsions (IVFEs) have evolved to become an integral component in the management of patients receiving home parenteral nutrition (HPN). IVFEs serve as a calorie source and provide essential fatty acids (linoleic acid and α-linolenic acid) in patients unable to achieve adequate intake of these fatty acids through alternative means. However, IVFE use is also associated with multiple complications, including increased infection risk, liver disease, and systemic proinflammatory states. In the United States, most IVFEs are composed of 100% soybean oil; internationally multiple alternative IVFEs (using fish oil, olive oil, and long- and medium-chain triglycerides) are available or being developed. The hope is that these IVFEs will prevent, or decrease the risk of, some of the HPN-associated complications. The goal of this article is to review how IVFEs came into use, their composition and metabolism, options for IVFE delivery in HPN, benefits and risks of IVFE use, and strategies to minimize the risks associated with IVFE use in HPN patients.

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Clinical, Ergonomic, and Economic Outcomes With Multichamber Bags Compared With (Hospital) Pharmacy Compounded Bags and Multibottle Systems: A Systematic Literature Review

Abstract: The systematic literature review identified evidence of potential clinical, ergonomic, and economic benefits for MCBs compared with COBs and MBSs; however, methodological factors limited evidence quality. More prospective studies are required to corroborate existing evidence.

Cited by 25 publications

References 47 publications

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Summary of Proceedings and Expert Consensus Statements From the International Summit “Lipids in Parenteral Nutrition”

Use of Intravenous Lipid Emulsions With Parenteral Nutrition: Practical Handling Aspects

Home Parenteral Nutrition

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