PARENTERAL NUTRITION IN NEONATUS AND COMPATIBILITY ISSUES: A REVIEW ARTICLE
DOI:
https://doi.org/10.22159/ajpcr.2017.v10i2.15697Abstract
Intravenous drug administration in Neonatal Intensive Care Unit is critical because of poor venous access, polymedication, fluid restriction, and low
infusion rate. Since parenteral nutrition (PN) is infused intravenously, it is often considered as a vehicle for medication administration. Medications
may be added to PN formulations in an effort to decrease fluid requirements, reduce the need for Y-site injections, reduce the possibility of line contamination due to manipulation, and decrease labor time required for drug administration. Risk is further increased by inadequate information on the physicochemical compatibility of drugs.
Keywords: Parenteral nutrition, Neonatus, Compatibility.
Downloads
References
NICE. Guideline, Nutrition Support in Adults. Excellence, UK: National Institute for Health and Clinical; 2006.
Wilmore DW, Dudrick SJ. Growth and development of an infant receiving all nutrients exclusively by vein. JAMA 1968;203:860-4.
American Society of Consultant Pharmacists. Consultant Pharmacists. Vol. 14. Arlington, VA: American Society of Consultant Pharmacists; 1999. p. 371-6.
Koletzko B, Goulet O, Hunt J, Krohn K, Shamir R; Parenteral Nutrition Guidelines Working Group, et al. Guidelines on paediatric parenteral nutrition of the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) and the European Society for Clinical Nutrition and Metabolism (ESPEN), Supported by the European Society of Paediatric Research (ESPR). J Pediatr
Gastroenterol Nutr 2005;41 Suppl 2:S1-87. 5. Mirtallo J, Canada T, Johnson D, Kumpf V, Petersen C, Sacks G, et al.
Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr 2004;28(6):S39-70.
Mirtallo J. Assessment Tools and Guidelines: Parenteral Nutrition Therapy. Cleveland, OH: McMahon Publishing; 2008.
Dudrick SJ, Wilmore DW, Vars HM, Rhoads JE. Long-term total parenteral nutrition with growth, development, and positive nitrogen
balance. Surgery 1968;64(1):134-42.
Heird WC, Driscoll JM Jr, Schullinger JN, Grebin B, Winters RW. Intravenous alimentation in pediatric patients. J Pediatr 1972;80:351-72.
Koletzko B. Early nutrition and its later consequences: New opportunities. Adv Exp Med Biol 2005;569:1-12.
Tsang R, Koletzko B, Uauy R, Zlotkin S. Nutrition of the Preterm Infant. Scientific Basis and Practical Application. Cincinnati: Digital
Educational Publishing; 2005.
Royal College of Paediatrics and Child Health. Withholding or Withdrawing Life Saving Treatment in Children. A Framework
Forpractice. London: RCPCH; 1997.
Brine E, Judith AE. Total parenteral nutrition for premature infants.Newborn Infant Nurs Rev 2004;4(3):133-55.
Lemons J, Bauer C, Oh W, Korones S, Papile L, Stoll B, et al. Very low birth weight outcomesof the National Institute of Child Health
and Human Development Neonatal Research Network, January 1995 through December 1996. Pediatrics 2001;107:el. Available from:
http://www.pediatrics.org/cgi/content/full/107/1/el.
Hack M, Fanaroff AA. Outcomes of children of extremely low birthweight and gestational age in the 1990’s. Early Hum Dev
;53:193-218.
Thureen P. Early aggressive nutrition in the neonate. NeoReviews 1999;20(9):e45-55.
Thureen PJ, Hay WW Jr. Intravenous nutrition and postnatal growth of the micropremie. Clin Perinatol 2000;27:197-219.
Thureen PJ, Melara D, Fennessey PV, Hay WW Jr. Effect of low versus high intravenous amino acid intake on very low birth weight infants in the early neonatal period. Pediatr Res 2003;53:24-32.
Heird W. The importance of early nutritional management oflowbirthweight infants. NeoReviews 1999;20:e43-4.
Poindexter B, Denne S. Protein needs of the preterm infant. NeoReviews 2003;4:E52-8.
Wilson D, Cairns P, Halliday H, Reid M, McClure G, Dodge. Randomized controlled trialof an aggressive nutritional regimen in
sick very low birthweight infants. Arch Dis Child Fetal Neonatal Ed 1997;77:4F-11.
Hay W, Lucas A, Heird W. Workshop summary: Nutrition of theextremely low birth weight infant. Pediatrics 1999;104:1360-8.
Dusick A, Vohr B, Steichen J, Wright L, Mele L. Factors affecting growthoutcome at 18 months in extremely low birthweight (ELBW)
infants. Pediatr Res 1998;43:213A.
Vohr BR, Wright LL, Dusick AM, Mele L, Verter J, Steichen JJ, et al.Neurodevelopmental and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Development Neonatal Research Network, 1993-1994. Pediatrics
;105(6):1216-26.
Price P. Parenteral nutrition: Administration and monitoring. In: GrohWargo S, Thompson M, Cox J, Hartline JV, editors. Nutritional Care for High-Risk Newborns. 3 ed. Chicago, IL: Precept Press; 2000. p. 91-118. rd
Anderson D. Parenteral nutrition: Fluid and electrolytes. In: GrohWargo S, Thompson M, Cox J, Hartline J, editors. Nutritional
Care for High-Risk Newborns. 3 ed. Chicago, IL: Precept Press; 2000. p. 109-18.
Ziegler EE, O’Donnell AM, Nelson SE, Fomon SJ. Body composition of the reference fetus. Growth 1976;40(4):329-41.
Peters O, Ryan S, Matthew L, Cheng K, Lunn J. Randomised controlled trial of acetate in preterm neonates receiving parenteral nutrition. Arch Dis Child Fetal Neonatal Ed 1997;77(1):F12-5.
Yardley R. Sodium, potassium and chloride. In: Yu V, MacMahon R, editors. Intravenous Feeding of the Neonate. London: EdwardArnold; 1992. p. 64-7.
Vileisis RA. Effect of phosphorus intake in total parenteral nutrition infusates in premature neonates. J Pediatr 1987;110:586-90.
Schanler RJ. The low birth weight infant. In: Walker WA, Watkins JB, Duggan C, editors. Nutrition in Pediatrics: Basic Science and Clinical Application. 3 ed. London: BC Decker; 2003. p. 491-514. 31. Krug S. Parenteral nutrition: Vitamins, minerals and trace elements. In: rd Groh-Wargo S, Thompson M, Cox J, Hartline JV, editors. Nutritional Care for High-Risk Newborns. 3 ed. Chicago, IL: Precept Press;
p. 151-76. rd
Hertz DE, Karn CA, Liu YM, Liechty EA, Denne SC. Intravenous glucose suppresses glucose production but not proteolysis in extremely premature newborns. J Clin Invest 1993;92:1752-8.
Sulkers EJ, Lafeber HN, Degenhart HJ, Przyrembel H, Schlotzer E, Sauer PJ. Effects of high carnitine supplementation on substrate
utilization in low-birth-weight infants receiving total parenteral nutrition. Am J Clin Nutr 1990;52:889-94.
Denne S, Poindexter B, Leitch C. Nutrition and metabolism in the highrisk neonate, Part 2: Parenteral nutrition. In: Fanaroff A, Martin
R, editors.Neonatal-Perinatal Medicine. 7 ed. St. Louis, MO: Mosby; 2002. p. 598-617.th
Leitch C, Denne S. Energy expenditure in the extremely low birth weight infant. In: Cowett R, editor. Nutrition and Metabolism of
the Micropremie. 1 ed., Vol. 27. Philadelphia, PA: Saunders; 2000.p. 181-95. St 36. Zlotkin SH, Bryan MH, Anderson GH. Intravenous nitrogen and energy intakes required to duplicate in utero nitrogen accretion in prematurely born human infants. J Pediatr 1981;99(1):115-20.
Bell E. Nutritional support. In: Goldsmith J, Karotkin E, editors. Assisted Ventilation of the Neonate. Philadelphia, PA: Saunders; 1996.
p. 381-95.
Ziegler EE. Protein in premature feeding. Nutrition 1994;10(1):69-71. 39. Thureen PJ, Anderson AH, Baron KA, Melara DL, Hay WW Jr, Fennessey PV. Protein balance in the first week of life in ventilated neonates receiving parenteral nutrition. Am J Clin Nutr
;68:1128-35.40. Premer DM, Georgieff MK. Nutrition for ill neonates. Pediatr Rev 1999;20:e56-62.
Denne SC, Kalhan SC. Glucose carbon recycling and oxidation in human newborns. Am J Physiol 1986;251:E71-7.
Lifshitz C. Carbohydrate Needs in Preterm and Term Infants. Vol. 122. Philadelphia, PA: Hanley and Belus; 1988.
Reiter P, Thureen P. Nutrition support in neonatology. In: Gottschlich M, editor. The Science and Practice of Nutrition Support: A Case-Based Core Curriculum. Dubuque, IA: Kendall/Hunt; 2001. p. 323-46.
Baker S, Davis A. Pediatric Parenteral Nutrition. New York: International Thomson Publishing; 1997.
Kanarek K, Santeiro M, Malone J. Continuous infusion of insulin in hyperglycemic low-birth weight infants receiving parenteral
nutrition with and without lipid emulsion. J Parenter Enteral Nutr 1991;15:417-20.
Henry B. Pediatric parenteral nutrition support. In: Nevin-Folino N, editor. Pediatric Manual of Clinical Dietetics. 2 ed. Chicago: Faulhabes; 2003. p. 495-514.
nd
Shulman RJ. New developments in total parenteral nutrition for children. Curr Gastroenterol Rep 2000;2:253-8.
American Academy of Pediatrics. Pediatric Nutrition Handbook.5 ed. Elk Grove Village, IL: American Academy of Pediatrics; 2004.
Aba-Sinden A, Bollinger R. Challenges and controversies in the th nutrition support of the preterm infant. Support Line 2002;2:2-15.
Heird WC, Gomez MR. Parenteral nutrition in low-birth-weight infants. Annu Rev Nutr 1996;16:471-99.
Ernst J, Gross S. Types and methods of feedings for infants. In: Polin R, Fox W, editors. Fetal and Neonatal Physiology. 2
Philadelphia, PA: Saunders; 1998. p. 363-82.
Hak EB, Storm MC, Helms RA. Chromium and zinc contamination of parenteral nutrient solution components commonly used in infants and children. Am J Health Syst Pharm 1998;55:150-4.
Denne SC, Karn CA, Ahlrichs JA, Dorotheo AR, Wang J, Liechty EA. Proteolysis and phenylalanine hydroxylation in response to parenteral nd ed. nutrition in extremely premature and normal newborns. J Clin Invest 1996;97:746-54.
Heird WC. Amino acid and energy needs of pediatric patients receiving parenteral nutrition. Pediatr Clin North Am 1995;42(4):765-89.
Heird W, Discoll J. Total parenteral nutrition. NeoReviews
;4:e137-9.
Van Goudoever JB, Colen T, Wattimena JL, Huijmans JG, Carnielli VP, Sauer PJ. Immediate commencement of amino acid upplementation in preterm infants: Effect on serum amino acid concentrations and protein kinetics on the first day of life. J Pediatr 1995;127:458-65.
Mayhew SL, Gonzalez ER. Neonatal nutrition: A focus on parenteral nutrition and early enteral nutrition. Nutr Clin Pract 2003;18(5):406-13.
Embleton N, Pang N, Cooke R. Postnatal malnutrition and growth retardation: An inevitable consequence of current recommendations in preterm infants? Pediatrics 2001;107(2):270-3.
Tubman TR, Thompson SW. Glutamine supplementation for prevention of morbidity in preterm infants. Cochrane Database Syst
Rev 2001;CD001457.
Poindexter BB, Ehrenkranz RA, Stoll BJ, Koch MA, Wright LL, Oh W, et al. Effect of parenteral glutamine supplementation on plasma
amino acid concentrations in extremely low-birth-weight infants. Am J Clin Nutr 2003;77:737-43.
Innis S. Fat. In: Tsang R, Lucas A, Uauy R, Zlotkin S, editors. Nutritional Needs of the Preterm Infant Scientific Basis and Practical
Guidelines. Baltimore, MD: Williams and Wilkins; 1993. p. 65-86.
Tsang R, Uauy R, Koletzko B, Zlotkin S, editors. Nutrition of the Preterm Infant: Scientific Basis and Practical Application. 2 ed. Cincinnati: Digital Educ Publ; 2005. p. 97-139.
Innis S. Lipids in parenteral nutrition. NeoReviews 2002;3(3):c48-55.
Uauy R, Treen M, Hoffman DR. Essential fatty acid metabolism and requirements during development. Semin Perinatol 1989;13:118-30.
Gustafson A, Kjellmer I, Olegard R. Nutrition in low-birthweight infants. I. Intravenous injection of fat emulsion. Acta Paediatr Scand 1972;61:149-58.
Putet G. Lipid metabolism of the micropremie. Clin Perinatol 2000;27:57-69, v-vi.
ASPEN Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition
in adult and pediatric patients. JPEN J Parenter Enteral Nutr 2002;26 1 Suppl:1SA-138.
Andrew G, Chan G, Schiff D. Lipid metabolism in the neonate. I. The effects of Intralipid infusion on plasma triglyceride and free fatty acid concentrations in the neonate. J Pediatr 1976;88(2):273-8.
Krug S. Osteopenia of prematurity. In: Groh-Wargo S, Thompson J, Cox T, editors. Nutritional Care for High Risk Newborns. 3 ed. Chicago, IL: Precept Press; 2000. p. 489-505.
Koo W, Tsang R. Mineral requirements of low-birth-weight infants. J Am Coll Nutr 1991;10:474-84.
Koo W, Steichen J. Osteopenia and rickets of prematurity. In: Polin R, Fox W, editors. Fetal and Neonatal Physiology. 2 ed. Philadelphia, PA: Saunders; 1998. p. 2335-49. nd
Prestridge LL, Schanler RJ, Shulman RJ, Burns PA, Laine LL. Effect of parenteral calcium and phosphorus therapy on mineral retention
and bone mineral content in very low birth weight infants. J Pediatr 1993;122:761-8.
Koo W, Tsang R. Calcium, phosphorus, magnesium and vitamin D requirements of infants receiving parenteral nutrition. In: Yu V, MacMahon R, editors. Intravenous Feeding of the Neonate. London: Edward Arnold; 1992. p.68-75.
Greene HL, Hambidge KM, Schanler R, Tsang RC. Guidelines for the use of vitamins, trace elements, calcium, magnesium, and phosphorus in infants and children receiving total parenteral nutrition: Report of the Subcommittee on Pediatric Parenteral Nutrient Requirements from the Committee on Clinical Practice Issues of the American Society for Clinical Nutrition. Am J Clin Nutr 1988;48:1324-42.
Tsang R, Lucas A, Uauy R, Zlotkin S. Nutritional Needs of the Preterm Infant: Scientific Basis and Practical Guidelines. Baltimore, MD: Williams and Wilkins; 1993.
Hardy G, Reilly C. Technical aspects of trace element supplementation.Curr Opin Clin Nutr Metab Care 1999;2:277-85.
Van Gossum A, Neve J. Trace element deficiency and toxicity. Curr Opin Clin Nutr Metab Care 1998;1(6):499-507.
Dickerson RN. Manganese intoxication and parenteral nutrition. Nutrition 2001;17(7-8):689-93.
Pluhator-Murton M, Fedorak R, Audette R, Marriage BJ, Yatscoff RW,
Gramlich LM. Trace element contamination of total parenteral nutrition. 1. Contribution of component solutions. JPEN J Parenter Enteral Nutr 1999;23(4):222-7.
Tyrala E. Trace elements. In: Yu V, MacMahon R, editors. Intravenous Feeding of the Neonate. London: Edward Arnold; 1992. p. 76-97.
Greer FR. Vitamin metabolism and requirements in the micropremie. Clin Perinatol 2000;27(1):95-118, vi.
Werkman SH, Peeples JM, Cooke RJ, Tolley EA, Carlson SE. Effect of vitamin A supplementation of intravenous lipids on early vitamin A intake and status of premature infants. Am J Clin Nutr 1994;59(3):586-92.
Laborie S, Lavoie JC, Pineault M, Chessex P. Protecting solutions of parenteral nutrition from peroxidation. JPEN J Parenter Enteral Nutr 1999;23(2):104-8.
Sax HC. Complications of total parenteral nutrition and their prevention. In: Rombeau JL, Caldwell MD, editors. Clinical Nutrition: Parenteral Nutrition. 2
ed. Philadelphia, PA: WB Saunders; 1993.
Safe practices for parenteral nutrition formulations. National Advisory nd
Group on Standards and Practice Guidelines for Parenteral Nutrition. JPEN J Parenter Enteral Nutr 1998;22(2):49-66.
Andris DA, Krzywda EA. Central venous access. Clinical practice issues. Nurs Clin North Am 1997;32:719-40.
Solomon SM, Kirby DF. The refeeding syndrome: A review. JPEN J Parenter Enteral Nutr 1990;14(1):90-7.
Skipper AL, Millikan KW. Parenteral nutrition implementation and management. In: The ASPEN Nutrition Support Practice Manual.
Silver Spring, MD: American Society for Parenteral and Enteral Nutrition; 1998.
McMahon M, Manji N, Driscoll DF, Bistrian BR. Parenteral
nutrition in patients with diabetes mellitus: Theoretical and practical considerations. JPEN J Parenter Enteral Nutr 1989;13(5):545-53.
Goff K. Metabolic monitoring in nutrition support. Nurs Clin North Am 1997;32:741-53.
Fleming CR. Hepatobiliary complications in adults receiving nutrition support. Dig Dis 1994;12(4):191-8.
Koo WW. Parenteral nutrition-related bone disease. JPEN J Parenter Enteral Nutr 1992;16:386-94.
Baumgartner TG. Trace elements in clinical nutrition. Nutr Clin Pract 1993;8:251-63.
Murphy LM, Lipman TO. Central venous catheter care in parenteral nutrition: A review. JPEN J Parenter Enteral Nutr 1987;11:190-201.
Pearson ML. Guideline for prevention of intravascular device-related infections. Hospital Infection Control Practices Advisory Committee. Infect Control Hosp Epidemiol 1996;17:438-73.
Pearson ML. Centers for Disease Control and Prevention: Guidelines for prevention of intravascular device-related infection. Part I. Intravascular device-related infections: An overview. TheHospital Infection Control Practices Advisory. Am J Infect Control
;24(4):262-77.
Kimble K, Lloyd YY, Wayne AK, Joseph G. Applied Therapeutics. 7 ed. Philadelphia, PA: Lippincott William; 2002.
Di Piro JT, Barbara GW, Terry LS, Cindy WH. Pharmacotherapy. 6th ed. New York: McGraw Hill; 2006.
David F. Driscoll. Stability and compatibility assessment techniques th for total parenteral nutrition admixtures: Setting the bar according to pharmacopeial standards. Curr Opin Clin Nutr Metab Care
;8(3):297-303. 100. Trissel LA, Gilbert DL, Martinez JF. Compatibility of parenteral nutrient solutions with selected drugs during simulated Y-site administration. Am J Health-Syst Pharm 1997;54:1295-1300.
Driscoll DF, Baptista RJ, Mitrano FP, Mascioli EA, Blackburn GL, Bistrian BR. Parenteral nutrient admixtures as drug vehicles: Theory and practice in the critical care setting. DICP 1991;25:276-83.
Hardy G, Ball P, McElroy B. Basic principles for compounding all-inone
Parenteral nutrition admixtures. Curr Opin Clin Nutr Metab Care 1998;1:291-6.
Trissel LA, Gilbert DL, Martinez JF, Baker MB, Walter WV, Mirtallo JM. Compatibility of medications with 3-in-1 parenteral
nutrition admixtures. JPEN J Parenter Enteral Nutr 1999;23(2):67-74. 104. King JC, Catania PN. Guide to Parenteral Admixtures. St. Louis, MO, USA: Pacemarq Inc.; 1991.
Mu¨hlebach S. Basics in clinical nutrition: Drugs and nutritional admixtures. eSPEN Eur eJ Clin Nutr Metab 2009;4:e134-6.
ASPEN Board of Directors and Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. Drug Nutr Interact JPEN 2002;26 1 Suppl:42SA.
Trissel LA. Handbook of Injectable Drugs. 14 ed. Bethesda, MD, USA: American Society of Hospital Pharmacists; 2007.
Published
How to Cite
Issue
Section
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.
