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Premixed vs Compounded Parenteral Nutrition: Effects of Total Parenteral Nutrition Shortage on Clinical Practice

  • Sara L. BonnesEmail author
  • Kerstin E. Austin
  • Jennifer J. Carnell
  • Bradley R. Salonen
Gastroenterology, Critical Care, and Lifestyle Medicine (SA McClave, Section Editor)
  • 14 Downloads
Part of the following topical collections:
  1. Topical Collection on Gastroenterology, Critical Care, and Lifestyle Medicine

Abstract

Purpose of Review

Drug shortages continue to impact our patients with intestinal failure and their ability to receive nutrition. ASPEN guidelines address the management of certain shortages in compounded total parenteral nutrition (TPN); however, some institutions have utilized premixed total parenteral nutrition (pTPN) in place of TPN.

Recent Findings

Premixed TPN appears to be as safe, if not safer, as compounded TPN when comparing the risk of bloodstream infection. However, there is an increased use of supplemental electrolytes to meet patient needs. Cost-effectiveness depends on multiple factors and should be evaluated by each institution when considering the use of TPN.

Summary

In light of the published information on the use of pTPN compared to TPN, institutions and nutrition clinicians should consider their current practice and opportunities to consider when pTPN may be beneficial for their patients, not only from a safety perspective, but also considering cost savings. However, close monitoring and individual patient needs should be considered as these formulas may not meet all patient nutritional and electrolyte needs.

Keywords

Parenteral nutrition Pre-mixed TPN TPN shortage TPN safety 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Sara L. Bonnes
    • 1
    Email author
  • Kerstin E. Austin
    • 2
  • Jennifer J. Carnell
    • 1
  • Bradley R. Salonen
    • 1
  1. 1.Division of General Internal MedicineMayo ClinicRochesterUSA
  2. 2.Division of Gastroenterology and HepatologyUniversity of WisconsinMadisonUSA

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