Parenteral nutrition with standard solutions in paediatric intensive care patients.
BACKGROUND
Paediatric intensive care patients often require parenteral nutrition (PN). Only very few standard mixtures are available for infants and children. Individual PN solutions need to be compounded manually on the ward, if preparation by the hospital pharmacy is not feasible. Since manual compounding is associated with a greater risk of compounding errors and microbial contamination, the use of standard solutions might be a preferable alternative.


METHODS
We evaluated the use of standard solutions on the paediatric intensive care unit of the von Hauner Children's Hospital at the University of Munich over a period of 8 months. PN solutions were either prescribed individually or as standard solutions. We evaluated the frequency of standard solution prescriptions and their modification, compared nutrient intakes with standard vs. individual PN solutions as well as the occurrence of laboratory anomalies.


RESULTS
Standard PN solutions were prescribed in 68% of cases, individual PN solutions in 32%. Modifications of standard PN solutions were performed in 54%. The intake of a number of macronutrients and electrolytes was similar with individual and standard PN, but calcium and phosphate intakes were lower with individual total PN. Electrolyte imbalances occurred slightly more often with individual PN than with standard PN (34% vs. 26%, respectively).


CONCLUSIONS
Standard PN solutions were used in the majority of patients on a paediatric intensive care unit. We did not detect indications for inadequacy of standard solutions in the majority of patients reviewed.
Krohn
Kathrin
K
Division of Metabolic Diseaseas and Nutritional Medicine, Dr. von Hauner Children's Hospital, University of Munich, Lindwurmstr, 4, D-80337 München, Germany. Kathrin.Krohn@med.uni-muenchen.de
Babl
Jürgen
J
Reiter
Karl
K
Koletzko
Berthold
B
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D016303:Clinical Pharmacy Information Systems; D004339:Drug Compounding / Q000009:adverse effects / Q000379:methods; D005260:Female; D005506:Food Contamination / Q000517:prevention & control; D005526:Food, Formulated / Q000032:analysis / Q000592:standards*; D006801:Humans; D007223:Infant; D007363:Intensive Care Units, Neonatal / Q000592:standards; D015278:Intensive Care Units, Pediatric / Q000592:standards; D008297:Male; D010288:Parenteral Nutrition / Q000379:methods / Q000592:standards*; D010607:Pharmacy Service, Hospital / Q000592:standards; D055656:Prescriptions / Q000592:standards*