The use of standardized commercially available parenteral nutrition as a bridge to customized compounded bag in the acute hospital setting is safe and feasible.

Abstract

The use of standardized commercially available parenteral nutrition (SCAPN) as a starter bag to bridge to customized compounded PN offers the advantage of starting PN on the same day of consult, avoiding delays in nutrition delivery. We aim to evaluate the safety and feasibility of using SCAPN as a bridge to compounded PN in the acute hospital setting. Retrospective review of patients on PN from Aug 2018 to Sep 2019 was performed. SMOFKABIVEN® Peripheral 800kcal in 1206ml was used. Electrolyte replacements on the day and the day after PN commencement were compared between SCAPN and compounded PN. Results were reported as means (95% confidence intervals). P value<0.05 was considered statistically significant. 135 (78.5%) patients received SCAPN while 37 (21.5%) received compounded PN on the first day of PN. Baseline characteristics of both groups were almost similar with higher BMI in the SCAPN. Baseline serum potassium 4.0 (3.9, 4.1) vs 4.0 (3.8, 4.1), p=0.46; phosphate 1.1 (1.0, 1.1) vs 1.1 (1.0, 1.3), p=0.40 and magnesium 0.8 (0.8, 0.9) vs 0.9 (0.9, 1.0), p<0.05 for SCAPN and compounded PN respectively. Follow-up serum potassium was 3.9 (3.8, 3.9) vs 3.9 (3.8, 4.1), p=0.36; phosphate 0.9 (0.9, 0.9) vs 1.1 (1.0, 1.2), p<0.05 and magnesium 0.9 (0.9, 0.9) vs 0.9 (0.9, 1.0), p=0.18. Baseline calories and protein were lower in SCAPN group. Electrolyte replacements were similar in both groups at baseline and follow up. Using our in-house protocol, the use of a SCAPN as a bridge to customized compounded PN is safe and feasible.