| Autor: |
Otero-Millán L; Pharmacy Department, University Hospital Complex of Vigo, 36312 Vigo, Spain.; NeumoVigo I+i Research Group, Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, 36312 Vigo, Spain., Bea-Mascato B; Innovation in Clinical Pharmacy Research Group (i-FARMA-Vigo), Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, 36312 Vigo, Spain., Legido Soto JL; Applied Physic Department, Faculty of Sciences, University of Vigo, 36310 Vigo, Spain., Martínez-López-De-Castro N; Pharmacy Department, University Hospital Complex of Vigo, 36312 Vigo, Spain.; Innovation in Clinical Pharmacy Research Group (i-FARMA-Vigo), Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, 36312 Vigo, Spain., Lago Rivero N; Pharmacy Department, University Hospital Complex of Vigo, 36312 Vigo, Spain.; Innovation in Clinical Pharmacy Research Group (i-FARMA-Vigo), Galicia Sur Health Research Institute (IIS Galicia Sur) SERGAS-UVIGO, 36312 Vigo, Spain. |
| Abstrakt: |
(1) Background: parenteral nutrition (PN) is indispensable for patients unable to receive oral or enteral feeding. However, the complexity of PN solutions presents challenges regarding stability and compatibility. Precipitation reactions may occur. The most frequent is the formation of calcium phosphate (Ca-P). The different factors influencing these reactions must be considered to ensure patient safety. (2) Methods: eight paediatric PN solutions were prepared, following standard protocols. Samples were stored at room temperature and in a refrigerator. Electron microscopy, coupled with energy dispersive X-ray spectroscopy (EDS), was employed. Precipitates were analysed for composition and morphology. (3) Results: precipitates were observed in all samples, even at day 0. Crystalline structures, predominantly composed of calcium or magnesium, sometimes associated with chlorine or phosphorus, were detected. Additionally, amorphous precipitates, contained heterogeneous compositions, including unexpected elements, were identified. (4) Conclusions: various precipitates, primarily calcium- or magnesium-based, can form in PN solutions, although it is not expected that they can form under the real conditions of use. Calcium oxalate precipitation has been characterised, but the use of organic calcium and phosphate salts appears to mitigate calcium phosphate precipitation. Electron microscopy provides interesting results on NP precipitation, but sample preparation may present technical limitations that affect the interpretation of the results. |
