Premixed vs Compounded Parenteral Nutrition: Effects of Total Parenteral Nutrition Shortage on Clinical Practice

Bonnes, Sara L.; Austin, Kerstin; Carnell, Jennifer; Salonen, Bradley R.

doi:10.1007/s13668-019-00291-3

Cited by 7 publications

(7 citation statements)

References 27 publications

(31 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Provide MCB-PN for Home PN (HPN) support. Patients receiving long-term PN, often started at the hospital with compounded PN and then administered at home after stabilizing the case and are generally provided with MCB-PN due to the stability and easy administration (Grade 1C) (Bonnes et al, 2019).…”

Section: Resultsmentioning

confidence: 99%

Strengths, weaknesses, opportunities, threats analysis on choice of multi chamber bag or compounded parenteral nutrition

Elnajjar¹,

Thomas²,

Tabbara³

et al. 2020

ijrps

View full text Add to dashboard Cite

Reasons for choosing parenteral nutrition (PN) products depend on healthcare institutions internal and external factors. A decision to start, continue, scale-up, scale down, or stop compounding of PN involves multiple stakeholders. This study is an effort to analyze such factors and recommendations on decision-making. A strength, weakness, opportunities, threats (SWOT) analysis was prepared in consultation with major PN providers in the UAE and comparing to international best practices. Based on the SWOT analysis, a set of recommendations was prepared using the GRADE system (classification of quality of evidence and strength of recommendation). Feedback on the SWOT analysis and recommendations were collected from the PN providers. The SWOT analysis and recommendations address aspects of the choice of MCB-PN or compounded PN. It includes considerations on PN indication, availability of ingredients, types of patients, safety, and cost management with labor, automation, and outsourcing. It was received well. The SWOT analysis and recommendations are useful in decision-making in complex therapy like PN. It helps in institutional decisions on choices of MCB-PN or compounded PN. The impact of the recommendations is to be measured in the future.

show abstract

Section: Resultsmentioning

confidence: 99%

Strengths, weaknesses, opportunities, threats analysis on choice of multi chamber bag or compounded parenteral nutrition

Elnajjar¹,

Thomas²,

Tabbara³

et al. 2020

ijrps

View full text Add to dashboard Cite

show abstract

“…O uso de formulações de NP comerciais prontas para uso é encorajado como uma opção terapêutica pelas diretrizes nacionais e internacionais e estudos sugerem que seu uso resulte em potenciais benefícios econômicos e menores taxas infecções da corrente sanguínea nos pacientes 6,7 . Ainda assim, observamos que a utilização de formulações manipuladas de NP continua sendo prática comum nos hospitais e seu uso ocorreu em mais da metade dos casos avaliados.…”

Section: Discussionunclassified

Nutrição parenteral hospitalar: um panorama nacional

Castro,

Toledo

2023

View full text Add to dashboard Cite

RESUMOIntrodução: O conhecimento do panorama geral relacionado à prescrição de nutrição parenteral (NP) no Brasil mostra-se de suma importância, uma vez que está relacionado ao desenvolvimento de melhorias do processo assistencial prestado aos pacientes. No entanto, ainda faltam dados nacionais que reflitam as atuais práticas realizadas e evidenciem a necessidade de aprimoramento. O objetivo do presente estudo foi compreender o perfil de uso de NP no Brasil, avaliando as práticas relacionadas à prescrição, bem como estimar a incidência de complicações relacionadas à NP. Método: Trata-se de estudo prospectivo e observacional. Foi realizada uma pesquisa junto a médicos pertencentes a Equipes Multiprofissionais de Terapia Nutricional (EMTN) em todo Brasil sobre a prática de prescrição e manejo de NP. Para tal análise, cada médico respondeu a um questionário, onde informava a forma em que conduzia a terapia nutricional de seus pacientes. Os dados foram compilados para análise do estudo. Cada participante informou sua prática clínica desde a prescrição da terapia até desmame da NP ou saída hospitalar (alta/óbito). Resultados: Ao todo, 16 médicos responderam à pesquisa, totalizando 78 pacientes acompanhados por esses médicos para análise do panorama da terapia nutricional de rotina empregada nos diferentes serviços. A maior parte dos pacientes que receberam NP possuía diagnóstico cirúrgico (71,8%). 89,2% dos pacientes apresentavam risco nutricional, sendo que 41,3% dos pacientes apresentavam desnutrição na avaliação nutricional. O uso de NP exclusiva ocorreu por 35,9% dos pacientes, enquanto a nutrição mista em 64,1%. Referente às características da terapia nutricional utilizada, 46,2% dos pacientes fizeram uso de bolsa pronta para uso, enquanto 53,8% deles fizeram uso de bolsa manipulada. A incidência de complicações foi de 66,7%, sendo a disglicemia a de maior frequência. Conclusão: A NP no Brasil parece ser utilizada conforme as diretrizes nacionais e internacionais. Nota-se uma necessidade de mais estudos que discutam as principais barreiras e dificuldades relacionadas à NP em nosso país.

show abstract

“…While various 3-chamber PN formulations have been available for more than 2 decades in Europe, the first 3-chamber PN formulation was not approved by the US Food and Drug Administration until 2014. 2,3 formulation. 4 Furthermore, a cost analysis of data from more than 400 US hospitals revealed a reduced costs when using MCB PN compared to customized PN, based on underlying reduced risk of infection.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Rate of Discontinuing Ready-to-Use Multi-Chamber Bag Parenteral Nutrition Secondary to High Serum Electrolyte Levels

et al. 2022

View full text Add to dashboard Cite

Background: Multi-chamber bag with electrolytes (MCB-E) parenteral nutrition (PN) formulations are gaining acceptance for nutritional support for safety and economic advantages. However, their use is hampered by serum electrolyte abnormalities. No data exist regarding MCB-E PN interruption due to high serum electrolyte levels. We assessed the rate of MCB-E PN discontinuation in surgical patients secondary to persistently high serum electrolyte levels. Methods: This prospective, cohort study included surgical patients (aged ≥18 years) who received MCB-E PN at King Faisal Specialist Hospital and Research Centre-Riyadh, from February 28, 2020, until August 30, 2021. Patients were followed for 30-day for the discontinuation of MCB-E PN secondary to persistent hyperphosphatemia, hyperkalemia, hypermagnesemia, or hypernatremia for two consecutive days. The association of discontinuing MCB-E PN with various factors was assessed using univariable and multivariable Poisson regression analysis. Results: Seventy-two patients were enrolled in the study, 55 (76.4%) completed MCB-E PN, whereas 17 (23.6%) patients discontinued MCB-E PN due to a persistent hyperphosphatemia (n = 13, 18%) and persistent hyperkalemia (n = 4, 5.5%). Hyperphosphatemia and hyperkalemia were observed at a median of 9 (IQR 6-15) days and 9.5 (IQR 7-12) days of MCB-E PN support, respectively. According to adjusted multivariable analysis, developing an episode of hyperphosphatemia or hyperkalemia was associated with MCB-E PN discontinuation (RR 6.62, 1.95-22.49; P = .002) and (RR 4.73, 1.30-17.24; P = .018), respectively. Conclusion: In surgical patients receiving short-term MCB-E PN, developing hyperphosphatemia was the most frequent high electrolyte abnormality assocaited with MCB-E PN discontinuation, followed by hyperkalemia.

show abstract

Premixed vs Compounded Parenteral Nutrition: Effects of Total Parenteral Nutrition Shortage on Clinical Practice

Cited by 7 publications

References 27 publications

Strengths, weaknesses, opportunities, threats analysis on choice of multi chamber bag or compounded parenteral nutrition

Strengths, weaknesses, opportunities, threats analysis on choice of multi chamber bag or compounded parenteral nutrition

Nutrição parenteral hospitalar: um panorama nacional

The Rate of Discontinuing Ready-to-Use Multi-Chamber Bag Parenteral Nutrition Secondary to High Serum Electrolyte Levels

Contact Info

Product

Resources

About