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Calcium Chloride and Sodium Phosphate in Neonatal Parenteral Nutrition Containing TrophAmine
Author(s) -
Migaki Evelyn A.,
Melhart Brian J.,
Dewar Christina J.,
Huston Robert K.
Publication year - 2012
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607111420154
Subject(s) - calcium , sodium , chemistry , phosphate , parenteral nutrition , potassium , phosphorus , precipitation , nuclear chemistry , zoology , medicine , biochemistry , biology , organic chemistry , physics , meteorology
Objectives : The objectives were to determine concentrations of calcium chloride (CaCl) and sodium phosphate (NaPhos) that can be safely added to TrophAmine‐based parenteral nutrition (PN) and to measure aluminum (Al) concentrations in PN solutions containing CaCl and NaPhos vs those containing calcium gluconate (CaGlu) and potassium phosphate (KPhos). Methods : In study A, PN solutions containing varying amounts of TrophAmine, CaCl, and NaPhos were compounded and then evaluated visually for precipitation. In study B, Al concentrations were measured in PN solutions containing CaCl and NaPhos (S1), CaGlu and NaPhos (S2), or CaGlu and KPhos (S3). Results : Study A showed that a maximum phosphorus concentration of 15 mmol/L could be added to a solution containing 12.5 mmol/L of calcium without evidence of precipitation when the amino acid (AA) concentration reached ≥3 g/dL (3%). In study B, the mean (range) Al concentrations were S1 = 2.2 (1.9–2.4), S2 = 8.5 (7.8–9.3), and S3 = 11.7 (10.8–12.2) µmol/L (means of 6.0, 22.9, and 31.5 micrograms/dL, respectively). Conclusions : The data can provide a guide for compounding neonatal PN solutions containing TrophAmine, CaCl, and NaPhos. More studies are needed to determine the long‐term effects of substituting CaCl for CaGlu in PN solutions for neonates. Substituting CaCl and NaPhos for CaGlu and KPhos significantly decreases Al concentrations in PN and potential Al exposure of neonatal patients.