title: Comparison of long-term stability of parenteral all-in-one admixtures containing new lipid emulsions prepared under hospital pharmacy conditions.
abstract: All-in-one (AIO) admixtures for parenteral nutrition are common in hospital pharmacy practices. They are extemporaneously prepared and should be stable during preparation, storage, and administration. Lipid emulsion is a clinically important and very susceptible component of instability. The objective of study was to evaluate the long-term stability of AIO admixtures containing modern lipid emulsions.
  
  
  METHODS
  AIO admixtures with two different emulsions (SMOFlipid and Lipoplus) containing the same amount of glucose and complex amino acid solution, and variable amounts of ions were prepared. Samples were evaluated at 2, 5, 8 and 30 days after preparation. The main indicator of AIO system stability was the amount of lipid globules greater than 5 μm in diameter, which is limited by pharmacopoeia. Optical microscopy was used for particle size measurement.
  
  
  RESULTS
  All prepared AIO admixtures remained stable during observation. The counts of overlimit lipid particles were within pharmacopeial limit nevertheless tended to increase in time. After 30-day storage, their value was influenced mainly by concentration of calcium ions, which at lower concentrations had a greater impact on SMOFlipid-based admixtures, whereas at the highest concentration on Lipoplus-based admixtures. The concentration of ions and osmolarity remained without changes; pH of admixtures slightly decreased.
  
  
  CONCLUSIONS
  Both lipid emulsions were found to be suitable for preparation AIO admixtures with different concentrations of electrolytes. The formulations were stable even if contained high concentrations of divalent ions. The comparison of emulsions revealed the superiority of Lipoplus - electrolyte concentrations and duration of storage had a greater impact on admixtures with SMOFlipid.
authors.affiliation: General University Hospital in Prague, Czech Republic.
authors.forename: Michal
authors.initials: M
authors.lastname: Janů
authors.forename: Helena
authors.initials: H
authors.lastname: Brodská
authors.forename: Marek
authors.initials: M
authors.lastname: Vecka
authors.forename: Ruta
authors.initials: R
authors.lastname: Masteiková
authors.forename: Eva
authors.initials: E
authors.lastname: Kotrlíková
authors.forename: Robertas
authors.initials: R
authors.lastname: Lažauskas
authors.forename: Rimantas
authors.initials: R
authors.lastname: Pečiūra
authors.forename: Jurga
authors.initials: J
authors.lastname: Bernatonienė
mesh_terms: D004355:Drug Stability; D004356:Drug Storage; D004655:Emulsions; D006761:Hospitals; D006863:Hydrogen-Ion Concentration; D007246:Infertility; D008055:Lipids / Q000737:chemistry*; D057947:Parenteral Nutrition Solutions / Q000737:chemistry*; D010607:Pharmacy Service, Hospital
chemical_list: D004655:Emulsions; D008055:Lipids; D057947:Parenteral Nutrition Solutions