3 Safer Total Parenteral Nutrition based on Speciation Analysis

Abstract

Publisher Summary This chapter describes each of the fundamental components of Total parenteral nutrition (TPN) fluids––namely, water, nitrogen and energy sources, minerals, vitamins, and administered drugs. The equations governing the physical chemistry are indicated and overlapping interactions are suggested. TPN is a means of providing all the nutritional requirements of seriously ill patients using carbohydrates, fats, nitrogen (as amino acids), electrolytes, trace elements, and vitamins so that a positive nutritional status is achieved. TPN may also be used to denote ‘total parenteral nutrition’ as in TPN fluid. The clinical uses of TPN are ahead of the scientific theories, but by a concentrated attack upon quantifying the speciation present in TPN fluids and plasma-TPN mixtures, it is possible to narrow this gap and to enhance safety considerations. The basic concept is that computer simulation of the speciation can be more thorough and give a more complete appraisal of species present in solution than is possible by solely experimental measurements of just one or two of the concentrations of the species more accessible to modern instrumentation. The simulation approach is to combine total concentrations of metals, amino acids, and ligands for a particular fluid with the appropriate formation constants and solubility products.