Prolonged peripheral parenteral nutrition with an ultrafine cannula and low-osmolality feed

Williams, Nigel; Wales, S.; Irving, M. H.

doi:10.1002/bjs.1800830137

Cited by 18 publications

(11 citation statements)

References 28 publications

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“…They found no difference in the incidence of thrombophlebitis. Similarly, Williams et al 22 demonstrated no significant difference in the incidence of thrombophlebitis between patients receiving lipid‐based feeds with an osmolality of 650 mosmol/kg and those receiving an osmolality of 860 mosmol/kg (13 and 18 per cent respectively). McMahon et al 13, 15, 23, 24 have for some years successfully used lipid‐based formulations with an osmolality greater than 1100 mosmol/kg, with phlebitis rates ranging between 7 and 26 per cent.…”

Section: Peripheral Vein Thrombophlebitismentioning

confidence: 94%

Sugar-Integrated Gelators of Organic Solvents

Gronwald¹,

Shinkai²

2001

Chem. Eur. J.

301

176

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Some methyl 4,6-O-benzylidene monosaccharides can act as strong low molecular weight gelators for various organic solvents. As they are accessible in a variety of homologues, each with a unique molecular architecture, they can be used for systematic studies of gelation phenomena. Structural details of their hydrogen-bond-based fiber network in the gel phase can be resolved by small angle X-ray scattering (SAXS). Analysis of the molecular arrangement in a single crystal can be a valuable tool for the prediction of gelation ability presupposing that the elongated shape of the gel fibers arises from an anisotropic assembly of the gelator molecules into one-dimensional aggregates. It is found that some derivatives act as "supergelators", which can gelate hydrocarbon solvents with 0.03-0.05 wt%. The recent results emerging from these investigations will be outlined in this article.

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Section: Peripheral Vein Thrombophlebitismentioning

confidence: 94%

Sugar-Integrated Gelators of Organic Solvents

Gronwald¹,

Shinkai²

2001

Chem. Eur. J.

301

176

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“…Other factors that may influence the incidence of thrombophlebitis include addition of heparin, 31,32 addition of corticosteroid, 31 or the presence of fat emulsion when PPN is prepared as a TNA. [32][33][34][35] The coinfusion of intravenous fat emulsion (IVFE) has not been shown to reduce phlebitis. 36,37 All available studies that have evaluated peripheral vein thrombophlebitis with infusion of PPN are limited by small sample size.…”

Section: Strongmentioning

confidence: 99%

A.S.P.E.N. Clinical Guidelines

Boullata

Gilbert

Sacks

et al. 2014

J Parenter Enteral Nutr

254

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Background: Parenteral nutrition (PN) is a high-alert medication available for patient care within a complex clinical process. Beyond application of best practice recommendations to guide safe use and optimize clinical outcome, several issues are better addressed through evidence-based policies, procedures, and practices. This document provides evidence-based guidance for clinical practices involving PN prescribing, order review, and preparation. Method: A systematic review of the best available evidence was used by an expert work group to answer a series of questions about PN prescribing, order review, compounding, labeling, and dispensing. Concepts from the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) format were applied as appropriate. The specific clinical guideline recommendations were developed using consensus prior to review and approval by the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) Board of Directors. The following questions were addressed: (1) Does education of prescribers improve PN ordering? (2) What is the maximum safe osmolarity of PN admixtures intended for peripheral vein administration? (3) What are the appropriate calcium intake and calciumphosphate ratios in PN for optimal neonatal bone mineralization? (4) What are the clinical advantages or disadvantages of commercially available premade ("premixed") multichambered PN formulations compared with traditional/customized PN formulations? (5) What are the clinical (infection, catheter occlusion) advantages or disadvantages of 2-in-1 compared with 3-in-1 PN admixtures? (6) What macronutrient dosing limits are expected to provide for the most stable 3-in-1 admixtures? (7) What are the most appropriate recommendations for optimizing calcium (gluconate) and (Na-or K-) phosphate compatibility in PN admixtures? (8) What micronutrient contamination is present in parenteral stock solutions currently used to compound PN admixtures? (9) Is it safe to use the PN admixture as a vehicle for non-nutrient medication delivery? (10) Should heparin be included in the PN admixture to reduce the risk of central vein thrombosis? (11) What methods of repackaging intravenous fat emulsion (IVFE) into smaller patient-specific volumes are safe? (12) What beyond-use date should be used for (a) IVFE dispensed for separate infusion in the original container and (b) repackaged IVFE? (JPEN J Parenter Enteral Nutr. 2014;38:334-377)

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“…The present authors have used standard feeds that offer full nutritional support, and the results clearly demonstrate that prolonged peripheral feeding does not require compromise of optimal protein and calorific provision 31 .…”

Section: Discussionmentioning

confidence: 65%