Physicochemical Stability of Hospital Parenteral Nutrition Solutions: Effect of Changes in Composition and Storage Protocol

Author:

Otero-Millán Luis12,Bea-Mascato Brais3,Legido Soto Jose Luis4,Martínez-López-De-Castro Noemi13,Lago-Rivero Natividad13ORCID

Affiliation:

1. Pharmacy Department, University Hospital Complex of Vigo, 36312 Vigo, Spain

2. NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain

3. Innovation in Clinical Pharmacy Research Group (i-FARMA-Vigo), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36312 Vigo, Spain

4. Applied Physic Department, Faculty of Sciences, University of Vigo, 36310 Vigo, Spain

Abstract

(1) Background: Parenteral nutrition (PN) is a technique used for the administration of nutrients to patients for whom traditional routes cannot be used. It is performed using solutions with extremely complex compositions, which can give rise to a large number of interactions. These interactions can impact their stability and put the patient’s life at risk. The aim of this study is to determine how changes in composition and storage protocol affect the stability of NP solutions. (2) Methods: Twenty-three samples were prepared according to routine clinical practice, with modifications to the concentration of some components. The samples were stored at room temperature (RT) and refrigerated (4 °C). Measurements of the droplet diameter, pH, density and viscosity were performed for both storage protocols on days 1, 3, 10 and 14. (3) Results: The samples with the lowest concentration of lipids (PN13-17) and proteins (PN18-22) showed a larger droplet diameter than the rest of the samples throughout the experiments. The USP limits were exceeded for some of the measurements of these sample groups. The pH density and viscosity remained relatively constant under the conditions studied. (4) Conclusions: The PN samples were considered stable and safe for administration under real-world conditions, but the samples with the lowest concentrations of lipids and proteins showed a tendency towards emulsion instability.

Publisher

MDPI AG

Reference39 articles.

1. ASPEN clinical Guidelines: Parenteral Nutrition Ordering, Order Review, Compounding, Labeling, and Dispensing;Boullata;JPEN J. Parenter. Enteral Nutr.,2014

2. ESPEN Guideline on Hospital Nutrition;Thibault;Clin. Nutr.,2021

3. Use of Intravenous Lipid Emulsions with Parenteral Nutrition: Practical Handling Aspects;Boullata;JPEN J. Parenter. Enteral Nutr.,2020

4. Consenso Español Sobre la Preparación de Mezclas Nutrientes Parenterales;Pera;Farm. Hosp.,2009

5. Planas, M. (2008). Conceptos Prácticos en Nutrición Enteral y Parenteral, Ediciones Mayo. [1st ed.].

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