Intravenous nutrition: focus on delivery (3-in-1 bags or not?).
The practicalities of providing intravenous nutrition support the use of 3-in-1 bags. However, problems with stability are an important consideration, especially because the clinical consequences can be devastating. Infusion sets designed with different colored tubing to decrease peroxide formation have been investigated. Also, even though high-dose heparin should not be combined with lipid emulsions, evidence for prescribing low dose in neonatal practice has been published. Furthermore, the largest study testing lipid stability with different drugs highlights 23 that should not be combined. Generation of oxalate as a marker of vitamin C loss and degradation of cocarboxylase have been investigated. Practical guidance has been published on the prevention of copper sulfide and iron phosphate precipitates. A study demonstrating that parenteral nutrition admixture is a poor growth medium has been reported. Finally, cyclical intravenous feeding may have a beneficial effect on the liver through protecting mitochondrial function from hypoxic damage.
Kitchen
P
P
St. Mark's Hospital, Harrow, Middlesex, United Kingdom. p.kitchen@ic.ac.uk
Forbes
A
A