title: Comparison Between Premixed and Compounded Parenteral Nutrition Solutions in Hospitalized Patients Requiring Parenteral Nutrition.
abstract: BACKGROUND
  Parenteral nutrition (PN) may be provided through compounded or premixed solutions.
  
  
  OBJECTIVE
  To determine the proportion of stable custom-compounded PN prescriptions that would fit within a 20% deviance of an existing premixed PN solution.
  
  
  METHODS
  A retrospective study design was used. Inpatients who received PN in non-critical care units in the preceding year were screened for eligibility. Results are reported descriptively as means (95% confidence intervals) and proportions.
  
  
  RESULTS
  We reviewed 97 PN prescriptions that met inclusion criteria. Stable hospital PN prescriptions compared with the reference premixed prescription provided 1838 (1777-1898) vs 1843 (1781-1905) kcal/d, P = .43; dextrose, 266 (254-277) vs 225 (216-234) g/d, P < .001; amino acids, 100 (95.9-104) vs 95.2 (91.7-98.7) g/d, P < .001; and lipids, 53.2 (51.3-55.1) vs 76.5 (73.8-79.2) g/d, P < .001. Fifty-eight of 97 (59.8%) matched for 2 of 3 macronutrients. Hospital compared with premixed lipid was lower 53.6 (43-64.2) g/d vs 75.5 (60.5-90.5) g/d, P < .001. Electrolytes differed between hospital and premixed solutions: sodium, 98.6 (95.0-102) vs 66.9 (64.6-69.9) mmol/L, P < .001; potassium, 93.7 (89.0-98.3) vs 57.4 (55.4-59.4) mmol/L, P < .001; and magnesium, 5.4 (4.8-5.4) vs 7.6 (7.4-7.9) mmol/L.
  
  
  CONCLUSIONS
  Calories and protein were remarkably similar, but dextrose, lipid, and electrolytes differed between hospital PN and the reference premixed prescription. We believe that there may be a role for premixed solutions in quaternary centers in stable non-critically ill patients.
authors.affiliation: Alberta Health Services, Calgary, AB, Canada.
authors.forename: Colleen
authors.initials: C
authors.lastname: Beattie
authors.affiliation: University of Toronto, Toronto, ON, Canada.
authors.forename: Johane
authors.initials: J
authors.lastname: Allard
authors.affiliation: University of Calgary, Calgary, AB, Canada mkothand@ucalgary.ca.
authors.forename: Maitreyi
authors.initials: M
authors.lastname: Raman
mesh_terms: D000596:Amino Acids / Q000032:analysis; D004041:Dietary Fats / Q000032:analysis; D004044:Dietary Proteins / Q000032:analysis; D004573:Electrolytes / Q000032:analysis; D002149:Energy Intake; D005260:Female; D005947:Glucose / Q000032:analysis; D006760:Hospitalization; D006801:Humans; D007362:Intensive Care Units; D008274:Magnesium / Q000032:analysis; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D057947:Parenteral Nutrition Solutions / Q000737:chemistry*; D011188:Potassium / Q000032:analysis; D055553:Prescription Drugs / Q000737:chemistry; D012189:Retrospective Studies; D012964:Sodium / Q000032:analysis
chemical_list: D000596:Amino Acids; D004041:Dietary Fats; D004044:Dietary Proteins; D004573:Electrolytes; D057947:Parenteral Nutrition Solutions; D055553:Prescription Drugs; D012964:Sodium; D008274:Magnesium; D005947:Glucose; D011188:Potassium
keywords: amino acids; drug compounding; electrolytes; glucose; intravenous fat emulsions; parenteral nutrition; parenteral nutrition solutions