Multi-chamber bag; Parenteral nutrition; Patient safety; Pediatrics; Preterm infants; Standardization; Parenteral Nutrition Solutions; Humans; Infant, Newborn; Infant; Child; Child, Preschool; Adolescent; Parenteral Nutrition Solutions/standards; Infant, Premature; Practice Guidelines as Topic; Infant, Very Low Birth Weight; Parenteral Nutrition/standards; Parenteral Nutrition/methods; Nutrition and Dietetics; Critical Care and Intensive Care Medicine
Abstract :
[en] Parenteral nutrition (PN) is recognized as a complex high-risk therapy. Its practice is highly variable and frequently suboptimal in pediatric patients. Optimizing care requires evidence, consensus-based guidelines, audits of practice, and standardized strategies. Several pediatric scientific organizations, expert panels, and authorities have recently recommended that standardized PN should generally be used over individualized PN in the majority of pediatric patients including very low birth weight premature infants. In addition, PN admixtures produced and validated by a suitably qualified institution are recommended over locally produced PN. Licensed multi chamber bags are standardized PN bags that comply with Good Manufacturing Practice and high-quality standards for the finished product in the frame of their full manufacturing license. The purpose of this article is to review the practical aspects of PN and the evidence for using such multi-chamber bags in pediatric patients. It highlights the safety characteristics and the limitations of the different PN practices and provides some guidance for ensuring safe and efficient therapy in pediatric patients.
Disciplines :
Pediatrics Endocrinology, metabolism & nutrition
Author, co-author :
Senterre, Thibault ; Université de Liège - ULiège > Département des sciences de la santé publique
van den Akker, Chris H P ; Department of Pediatrics - Neonatology, Amsterdam UMC, University of Amsterdam, Emma Children's Hospital, Amsterdam, the Netherlands, Amsterdam Reproduction and Development and Amsterdam Gastroenterology Endocrinology Metabolism Research Institutes, Amsterdam, the Netherlands. Electronic address: c.h.vandenakker@amsterdamumc.nl
Domellof, Magnus ; Department of Clinical Sciences, Umeå University, Umea, Sweden. Electronic address: magnus.domellof@umu.se
Saenz de Pipaon, Miguel; Instituto de Investigación Sanitaria del Hospital Universitario La Paz - IdiPAZ, (Hospital Universitario La Paz - Universidad Autónoma de Madrid), Madrid, Spain. Electronic address: miguel.saenz@salud.madrid.org
Arnell, Henrik ; Department of Pediatric Gastroenterology, Hepatology and Nutrition, Astrid Lindgren Children's Karolinska University Hospital, Stockholm, Sweden, Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden. Electronic address: henrik.arnell@karolinska.se
Tabbers, Merit; Amsterdam Reproduction and Development and Amsterdam Gastroenterology Endocrinology Metabolism Research Institutes, Amsterdam, the Netherlands, Department of Pediatric Gastroenterology, Hepatology and Nutrition, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands. Electronic address: m.m.tabbers@amsterdamumc.nl
Valla, Frederic V ; Transversal dietetics and Nutrition Unit and Nutrition Unit (UTDN), Intensive Care Nutrition, Hospices Civils de Lyon, Lyon-Bron, France. Electronic address: frederic.valla@chu-lyon.fr
Tomlin, Stephen ; Pharmacy Department, Children's Medicines Centre, Great Ormond Street Hospital for Sick Children, London, UK. Electronic address: Stephen.Tomlin@gosh.nhs.uk
Paulsson, Mattias ; Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden. Electronic address: Mattias.paulsson@kbh.uu.se
Wackernagel, Dirk ; Department of Neonatology, Gutenberg University, Mainz, Germany, CLINTEC, Karolinska Institutet, Stockholm, Sweden. Electronic address: dirk.wackernagel@unimedizin-mainz.de
Haiden, Nadja ; Department of Neonatology, Kepler University Hospital, Linz, Austria. Electronic address: nadja@haiden.eu
Luukkainen, Päivi ; Children's Hospital, University of Helsinki, Helsinki, Finland. Electronic address: Paivi.Luukkainen@hus.fi
Orfeo, Luigi; Neonatal Intensive Care Unit, Isola Tiberina Hospital Gemelli Isola, Rome, Italy. Electronic address: orfeo@iol.it
Carnielli, Virgilio P; Department of Mother and Child Health, Division of Neonatology, G. Salesi Children's Hospital - Azienda Ospedaliero Universitaria Ospedali Riuniti di Ancona, Ancona, Italy, Department of Odontostomatologic and Specialized Clinical Sciences, Polytechnic University of Marche, Ancona, Italy. Electronic address: v.carnielli@staff.univpm.it
Rigo, Jacques ; Université de Liège - ULiège > Département des sciences cliniques
ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition. Clin Nutr 37:6 Pt B (2018), 2303–2429.
HCUP National Inpatient Sample (NIS)., 2016, Agency for Healthcare Research and Quality (AHRQ) www.HCUPnet.ahrq.gov. (Accessed 26 February 2019)
Mundi, M.S., Pattinson, A., McMahon, M.T., Davidson, J., Hurt, R.T., Prevalence of home parenteral and enteral nutrition in the United States. Nutr Clin Pract 32:6 (2017), 799–805.
Johnson, M.J., Lapillonne, A., Bronsky, J., Domellof, M., Embleton, N., Iacobelli, S., et al. Research priorities in pediatric parenteral nutrition: a consensus and perspective from ESPGHAN/ESPEN/ESPR/CSPEN. Pediatr Res 92:1 (2022), 61–70.
Grover, A., Khashu, M., Mukherjee, A., Kairamkonda, V., Iatrogenic malnutrition in neonatal intensive care units: urgent need to modify practice. JPEN - J Parenter Enter Nutr 32:2 (2008), 140–144.
Lapillonne, A., Carnielli, V.P., Embleton, N.D., Mihatsch, W., Quality of newborn care: adherence to guidelines for parenteral nutrition in preterm infants in four European countries. BMJ Open, 3(9), 2013, e003478.
Stewart, J.A.D., Mason, D.G., Smith, N., Protopapa, K., Mason, M., A mixed bag - an enquiry into the care of hospital patients receiving parenteral nutrition., 2010 June, NCEPOD - National Confidential Enquiry into Patient Outcome and Death, London, England Report No.: 978-0-9560882-3-9.
Guenter, P., Boullata, J.I., Ayers, P., Gervasio, J., Malone, A., Raymond, E., et al. Standardized competencies for parenteral nutrition prescribing: the American society for parenteral and enteral nutrition model. Nutr Clin Pract 30:4 (2015), 570–576.
Mistry, P., Smith, R.H., Fox, A., Patient safety incidents related to the use of parenteral nutrition in all patient groups: a systematic scoping review. Drug Saf 45:1 (2022), 1–18.
Guenter, P., Ayers, P., Boullata, J.I., Gura, K.M., Holcombe, B., Sacks, G.S., Parenteral nutrition errors and potential errors reported over the past 10 years. Nutr Clin Pract 32:6 (2017), 826–830.
Kraft, M.D., Tucker, A.M., Durfee, S.M., Jones, T., Guenter, P., Banko, D.E., et al. Parenteral nutrition prescribing and order review safety study: the need for pharmacist intervention. Nutr Clin Pract 36:2 (2021), 480–488.
National Institute for Health and Care Excellence. Neonatal parenteral nutrition NICE guideline [NG154]. 26 February. 2020, National Institute for Health and Care Excellence [Available from: https://www.nice.org.uk/guidance/ng154.
Hoffmann, J., Haiden, N., Babl, J., Fusch, C., Piening, B., Schubert, S., et al. Parenteral nutrition in German perinatal centers results of a survey on barriers to clinical application (2021). 2021, Monatsschr Kinderh.
Boullata, J.I., Gilbert, K., Sacks, G., Labossiere, R.J., Crill, C., Goday, P., et al. A.S.P.E.N. clinical guidelines: parenteral nutrition ordering, order review, compounding, labeling, and dispensing. JPEN - J Parenter Enter Nutr 38:3 (2014), 334–377.
Robinson, D.T., Calkins, K.L., Chen, Y., Cober, M.P., Falciglia, G.H., Church, D.D., et al. Guidelines for parenteral nutrition in preterm infants: the American society for parenteral and enteral nutrition. JPEN J Parenter Enteral Nutr 47:7 (2023), 830–858.
Moltu, S.J., Bronsky, J., Embleton, N., Gerasimidis, K., Indrio, F., Koglmeier, J., et al. Nutritional management of the critically ill neonate: a position paper of the ESPGHAN committee on nutrition. J Pediatr Gastroenterol Nutr 73:2 (2021), 274–289.
Compher, C., Bingham, A.L., McCall, M., Patel, J., Rice, T.W., Braunschweig, C., et al. Guidelines for the provision of nutrition support therapy in the adult critically ill patient: the American Society for Parenteral and Enteral Nutrition. JPEN - J Parenter Enter Nutr 46:1 (2022), 12–41.
Kochevar, M., Guenter, P., Holcombe, B., Malone, A., Mirtallo, J., Directors, ABo, et al. ASPEN statement on parenteral nutrition standardization. JPEN - J Parenter Enter Nutr 31:5 (2007), 441–448.
Singer, P., Blaser, A.R., Berger, M.M., Alhazzani, W., Calder, P.C., Casaer, M.P., et al. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr 38:1 (2019), 48–79.
Haute Autorité de Santé (HAS). Nutrition parentérale en néonatologie - Recommandation de bonne pratique. 2018, Haute Autorité de Santé, Paris [Available from: https://www.has-sante.fr/jcms/c_2859140/en/nutrition-parenterale-en-neonatologie-recommandation-de-bonne-pratique.
The European Statements of Hospital Pharmacy. Eur J Hosp Pharm Sci Pract 21:5 (2014), 256–258.
EU Committee of Minister. Resolution CM/Res(2016)2 on good reconstitution practices in health care establishments for medicinal products for parenteral use. 2016.
Sacks, G.S., Rough, S., Kudsk, K.A., Frequency and severity of harm of medication errors related to the parenteral nutrition process in a large university teaching hospital. Pharmacotherapy 29:8 (2009), 966–974.
Long, A.L., Horvath, M.M., Cozart, H., Eckstrand, J., Whitehurst, J., Ferranti, J., Tailoring adverse drug event surveillance to the paediatric inpatient. Qual Saf Health Care, 19(5), 2010, e40.
Institute for Safe Medication Practices. Results of ISMP survey on high-alert medications: differences between nursing, pharmacy, and risk/quality/safety perspectives. ISMP Medication Safety Alert! 10:2 (2012), 1–4.
Hermanspann, T., Schoberer, M., Robel-Tillig, E., Hartel, C., Goelz, R., Orlikowsky, T., et al. Incidence and severity of prescribing errors in parenteral nutrition for pediatric inpatients at a neonatal and pediatric intensive care unit. Front Pediatr, 5, 2017, 149.
Cies, J.J., Moore, W.S. 2nd, Neonatal and pediatric peripheral parenteral nutrition: what is a safe osmolarity?. Nutr Clin Pract 29:1 (2014), 118–124.
Fessler, A.G., Rejrat, C.E., Re-Evaluating safe osmolarity for peripheral parenteral nutrition in neonatal intensive care patients. J Pediatr Pharmacol Therapeut 26:6 (2021), 632–637.
Späth, C., Zamir, I., Sjöström, E.S., Domellöf, M., Use of concentrated parenteral nutrition solutions is associated with improved nutrient intakes and postnatal growth in very low-birth-weight infants. J Parenter Enteral Nutr 44:2 (2020), 327–336.
Morgan, C., Tan, M., Attainment targets for protein intake using standardised, concentrated and individualised neonatal parenteral nutrition regimens. Nutrients, 11(9), 2019, 2167.
Giretti, I., D'Ascenzo, R., Correani, A., Antognoli, L., Monachesi, C., Biagetti, C., et al. Hypertriglyceridemia and lipid tolerance in preterm infants with a birth weight of less than 1250 g on routine parenteral nutrition. Clin Nutr 40:6 (2021), 4444–4448.
Alburaki, W., Yusuf, K., Dobry, J., Sheinfeld, R., Alshaikh, B., High early parenteral lipid in very preterm infants: a randomized-controlled trial. J Pediatr 228 (2021), 16–23 e1.
dit Trolli, S.E., Kermorvant-Duchemin, E., Huon, C., Bremond-Gignac, D., Lapillonne, A., Early lipid supply and neurological development at one year in very low birth weight (VLBW) preterm infants. Early Hum Dev 88:Suppl 1 (2012), S25–S29.
Beauport, L., Schneider, J., Faouzi, M., Hagmann, P., Huppi, P.S., Tolsa, J.F., et al. Impact of early nutritional intake on preterm brain: a magnetic resonance imaging study. J Pediatr 181 (2017), 29–36 e1.
Stoltz Sjostrom, E., Lundgren, P., Ohlund, I., Holmstrom, G., Hellstrom, A., Domellof, M., Low energy intake during the first 4 weeks of life increases the risk for severe retinopathy of prematurity in extremely preterm infants. Arch Dis Child Fetal Neonatal Ed 101:2 (2016), F108–F113.
Cober, M.P., Repackaging of intravenous fat emulsions: a clinical conundrum. Nutr Clin Pract 31:5 (2016), 642–646.
Blackmer, A.B., Partipilo, M.L., Three-in-one parenteral nutrition in neonates and pediatric patients: risks and benefits. Nutr Clin Pract 30:3 (2015), 337–343.
Setoguchi, M., Muto, M., Ohata, T., Fukuoka, R., Ikeda, H., Aki, H., et al. Syringe-dispensed omega-3 lipid injectable emulsions should be stored under airtight refrigeration: a proposal for the efficient supply of unapproved precious lipid resources. JPEN - J Parenter Enter Nutr 46:8 (2022), 1923–1931.
Chuo, J., Lambert, G., Hicks, R.W., Intralipid medication errors in the neonatal intensive care unit. Joint Comm J Qual Patient Saf 33:2 (2007), 104–111.
Low, E., Ryan, C.A., Overdose of intravenous intralipid in a premature neonate. Joint Comm J Qual Patient Saf 33:10 (2007), 588–589 author reply 9-90.
Hicks, R.W., Becker, S.C., Chuo, J., A summary of NICU fat emulsion medication errors and nursing services: data from MEDMARX. Adv Neonatal Care 7:6 (2007), 299–308 quiz 9-10.
NHS Patient safety alert. Risk of severe harm and death from infusing total parenteral nutrition too rapidly in babies. 2017, National Health Service [updated 27 September 2017. Available from: https://www.england.nhs.uk/publication/patient-safety-alert-infusing-total-parenteral-nutrition-too-rapidly-in-babies/.
Badr, M., Goulard, M., Theret, B., Roubertie, A., Badiou, S., Pifre, R., et al. Fatal accidental lipid overdose with intravenous composite lipid emulsion in a premature newborn: a case report. BMC Pediatr, 21(1), 2021, 584.
De Cloet, J., Van Biervliet, S., Van Winckel, M., Physicochemical stable standard all-in-one parenteral nutrition admixtures for infants and children in accordance with the ESPGHAN/ESPEN guidelines. Nutrition 49 (2018), 41–47.
Laborie, S., Denis, A., Dassieu, G., Bedu, A., Tourneux, P., Pinquier, D., et al. Shielding parenteral nutrition solutions from light: a randomized controlled trial. JPEN - J Parenter Enter Nutr 39:6 (2015), 729–737.
Bouchoud, L.U., Fonzo-Christe, C.A., Sadeghipour, F.A., Bonnabry, P., How standardized are pediatric parenteral nutrition formulations in Europe?. EJHP Sci 16:1 (2010), 1–4.
Boullata, J.I., Overview of the parenteral nutrition use process. JPEN - J Parenter Enter Nutr 36:2 Suppl (2012), 10S–13S.
The provision of parenteral nutrition within neonatal services - a framework for practice (2016), 2016, British Association of Perinatal Medicine, London [updated 30 April 2016. Available from: https://www.bapm.org/resources/42-the-provision-of-parenteral-nutrition-within-neonatal-services-a-framework-for-practice-2016.
Cassano, A.T., Parenteral nutrition training for the pharmacy team: focus on pharmacy technicians. JPEN - J Parenter Enter Nutr 36:2 Suppl (2012), 48S–50S.
Boullata, J.I., Mirtallo, J.M., Sacks, G.S., Salman, G., Gura, K., Canada, T., et al. Parenteral nutrition compatibility and stability: a comprehensive review. JPEN - J Parenter Enter Nutr 46:2 (2022), 273–299.
Lapillonne, A., Kermorvant-Duchemin, E., A systematic review of practice surveys on parenteral nutrition for preterm infants. J Nutr 143:12 Suppl (2013), 2061S–2065S.
Walter, E., Liu, F.X., Maton, P., Storme, T., Perrinet, M., von Delft, O., et al. Cost analysis of neonatal and pediatric parenteral nutrition in Europe: a multi-country study. Eur J Clin Nutr 66:5 (2012), 639–644.
Sommer, I., Bouchoud, L., Berger-Gryllaki, M., Bonnabry, P., Sadeghipour, F., Quality and safety of parenteral nutrition for newborn and preterm infants as an on-ward preparation. Eur J Hosp Pharm 27:5 (2020), 292–296.
Senterre, T., Rigo, J., Optimizing early nutritional support based on recent recommendations in VLBW infants and postnatal growth restriction. J Pediatr Gastroenterol Nutr 53:5 (2011), 536–542.
Simmer, K., Rakshasbhuvankar, A., Deshpande, G., Standardised parenteral nutrition. Nutrients 5:4 (2013), 1058–1070.
Evering, V.H.M., Andriessen, P., Duijsters, C.E.P.M., Brogtrop, J., Derijks, L.J.J., The effect of individualized versus standardized parenteral nutrition on body weight in very preterm infants. J Clin Med Res 9:4 (2017), 339–344.
Bigioni, F., Verlato, G., De Lorenzi, L., Frigo, A.C., Gaio, P., Di Lenardo, E., et al. Assessment of standardised parenteral nutrition in paediatrics. Eur J Clin Nutr 68:4 (2014), 535–536.
Krohn, K., Babl, J., Reiter, K., Koletzko, B., Parenteral nutrition with standard solutions in paediatric intensive care patients. Clin Nutr 24:2 (2005), 274–280.
Yailian, A.L., Serre, C., Fayard, J., Faucon, M., Thomare, P., Filali, S., et al. Production and stability study of a hospital parenteral nutrition solution for neonates. J Pharm Anal 9:2 (2019), 83–90.
Mena, K.D.R., Espitia, O.L.P., Vergara, J.A.D., Management of ready-to-use parenteral nutrition in newborns: systematic review. JPEN - J Parenter Enter Nutr 42:7 (2018), 1123–1132.
Brennan, A.M., Kiely, M.E., Fenton, S., Murphy, B.P., Standardized parenteral nutrition for the transition phase in preterm infants: a bag that fits. Nutrients, 10(2), 2018.
Mihatsch, W., Jimenez Varas, M.A., Diehl, L.L., Carnielli, V., Schuler, R., Gebauer, C., et al. Systematic review on individualized versus standardized parenteral nutrition in preterm infants. Nutrients, 15(5), 2023.
Lapillonne, A., Fellous, L., Kermorvant-Duchemin, E., [Use of standardized parenteral solutions in French neonatal departments: results of a national survey]. Arch Pediatr 16:10 (2009), 1329–1336.
Senterre, T., Abu Zahirah, I., Pieltain, C., de Halleux, V., Rigo, J., Electrolyte and mineral homeostasis after optimizing early macronutrient intakes in VLBW infants on parenteral nutrition. J Pediatr Gastroenterol Nutr 61:4 (2015), 491–498.
Berlana, D., Almendral, M.A., Abad, M.R., Fernández, A., Torralba, A., Cervera-Peris, M., et al. Cost, time, and error assessment during preparation of parenteral nutrition: multichamber bags versus hospital-compounded bags. J Parenter Enteral Nutr 43:4 (2019), 557–565.
Slattery, E., Rumore, M.M., Douglas, J.S., Seres, D.S., 3-in-1 vs 2-in-1 parenteral nutrition in adults: a review. Nutr Clin Pract 29:5 (2014), 631–635.
EU Commission Directive 2003/94/EC of 8 October 2003 - Laying down the principles and guidelines of good manufacturing practice in respect of medicinal products for human use and investigational medicinal products for human use.
Numeta G13E - a quick reference guide to additions and stability, 2020, Baxter International Inc., Deerfield, IL.
Rigo, J., Marlowe, M.L., Bonnot, D., Senterre, T., Lapillonne, A., Kermorvant-Duchemin, E., et al. Benefits of a new pediatric triple-chamber bag for parenteral nutrition in preterm infants. J Pediatr Gastroenterol Nutr 54:2 (2012), 210–217.
Staven, V., Wang, S., Gronlie, I., Tho, I., Physical stability of an all-in-one parenteral nutrition admixture for preterm infants upon mixing with micronutrients and drugs. Eur J Hosp Pharm 27:1 (2020), 36–42.
Rossholt, M.E., Bratlie, M., Wendel, K., Aas, M.F., Gunnarsdottir, G., Fugelseth, D., et al. A standardized feeding protocol ensured recommended nutrient intakes and prevented growth faltering in preterm infants < 29 weeks gestation. Clin Nutr ESPEN. 53 (2023), 251–259.
Nezvalova-Henriksen, K., Nilsson, N., Østerberg, C.T., Staven Berge, V., Tho, I., Y-Site physical compatibility of Numeta G13E with drugs frequently used at neonatal intensive care. Pharmaceutics, 12(7), 2020, 677.
Nilsson, N., Storesund, I., Tho, I., Nezvalova-Henriksen, K., Co-administration of drugs with parenteral nutrition in the neonatal intensive care unit-physical compatibility between three components. Eur J Pediatr 181:7 (2022), 2685–2693.
Staven, V., Iqbal, H., Wang, S., Grønlie, I., Tho, I., Physical compatibility of total parenteral nutrition and drugs in Y-site administration to children from neonates to adolescents. J Pharm Pharmacol 69:4 (2017), 448–462.
Stawny, M., Gostynska, A., Nadolna, M., Jelinska, A., Safe practice of Y-site drug administration: the case of colistin and parenteral nutrition. Pharmaceutics, 12(3), 2020.
Ross, E.L., Petty, K., Salinas, A., Bremmer, J., Her, C., Carpenter, J.F., Physical compatibility of Y-site pediatric drug administration: a call for question of us Pharmacopeia standards. J Pediatr Pharmacol Therapeut 28:1 (2023), 84–92.
Vega, Diaz EN., Miranda Barros, A.A., Castelo Reyna, M.A., Tenelanda Lopez, D., Tubon, I., Negative outcomes associated with medication in neonates on parenteral nutrition therapy. Pediatr Rep 15:2 (2023), 360–372.
Farhan, M., McCallion, N., Bennett, J., Cram, A., O'Brien, F., Stability and compatibility of parenteral nutrition solutions; a review of influencing factors. Eur J Pharm Biopharm 187 (2023), 87–95.
Cogle, S.V., Martindale, R.G., Ramos, M., Roberti, G.J., Roberts, P.R., Taylor, K., et al. Multicenter prospective evaluation of parenteral nutrition preparation time and resource utilization: 3-chamber bags compared with hospital pharmacy-compounded bags. JPEN J Parenter Enteral Nutr, 2020.
Haute Autorite de Santé (HAS). Comité de la Transparence. Pediaven_19-10-2011_Avis_10821. 2011, Haute Autorite de Santé.
Colomb, V., Commercially premixed 3-chamber bags for pediatric parenteral nutrition are available for hospitalized children. J Nutr 143:12 (2013), 2071S–2076S.
Colomb, V., Marlowe, M.L., Bonnot, D., Rigo, J., Practical use of a new three-chamber bag for parenteral nutrition in pediatric patients. Clin Nutr ESPEN 7:2 (2012), e93–e99.
Kreissl, A., Repa, A., Binder, C., Thanhaeuser, M., Jilma, B., Berger, A., et al. Clinical experience with Numeta in preterm infants: impact on nutrient intake and costs. J Parenter Enteral Nutr 40:4 (2016), 536–542.
Arnell, H., Valla, F.V., Malfilâtre, G., Pladys, P., Senterre, T., Pontes-Arruda, A., Safety of a triple-chamber bag parenteral nutrition in children ages up to 24 Months: an observational study. J Pediatr Gastroenterol Nutr 69:6 (2019), e151–e157.
Immeli, L., Mäkelä, P.M., Leskinen, M., Rinta-Koski, O.-P., Sund, R., Andersson, S., et al. A triple-chamber parenteral nutrition solution was associated with improved protein intake in very low birthweight infants. Acta Paediatr 109:8 (2020), 1588–1594.
Nagelkerke, S.C.J., Jonkers-Schuitema, C.F., Kastelijn, W.L.M., Gerards, A.E., Benninga, M.A., de Koning, B.A.E., et al. Standardized and individualized parenteral nutrition mixtures in a pediatric home parenteral nutrition population. J Pediatr Gastroenterol Nutr 70:2 (2020), 269–274.
Spath, C., Sjostrom, E.S., Domellof, M., Higher parenteral electrolyte intakes in preterm infants during first week of life: effects on electrolyte imbalances. J Pediatr Gastroenterol Nutr 75:3 (2022), e53–e59.
Batteux, M., Meers, G., Fien, B., Cortoos, P.J., Cools, F., The use of standardized solutions instead of individualized prescriptions for parenteral nutrition on the neonatal intensive care unit in uz brussel: a feasibility study. Clin Pediatr 63:5 (2023), 642–649.
Iacobelli, S., Bonsante, F., Vintejoux, A., Gouyon, J.B., Standardized parenteral nutrition in preterm infants: early impact on fluid and electrolyte balance. Neonatology 98:1 (2010), 84–90.
Ferreira, M., Guerra, P., Ferreras, C., Espinheira, M.D.C., Trindade, E., Dias, J.A., Could commercial formulations replace individualized prescription in pediatric home parenteral nutrition?. J Pediatr Gastroenterol Nutr 73:4 (2021), 548–554.
Pironi, L., Boeykens, K., Bozzetti, F., Joly, F., Klek, S., Lal, S., et al. ESPEN guideline on home parenteral nutrition. Clin Nutr 39:6 (2020), 1645–1666.
Jandot, E., Savelli, M., Pinte, G., Sutherland, A., Quessada, T., Valla, F.V., Supplementations of industrial multichamber parenteral nutrition bags in critically ill children: safety of the practice. Nutr Clin Pract 38:3 (2022), 698–706.
Kriz, A., Wright, A., Paulsson, M., Tomlin, S., Simchowitz, V., Senterre, T., et al. Cost-consequences analysis of increased utilization of triple-chamber-bag parenteral nutrition in preterm neonates in seven European countries. Nutrients, 12(9), 2020.
Hill, S., Use of standard parenteral nutrition bags in a paediatric home parenteral nutrition population. J Pediatr Gastroenterol Nutr 70:2 (2020), 160–161.
Chhim, R.F., Crill, C.M., Premixed parenteral nutrition solution use in children. J Pediatr Pharmacol Therapeut 20:5 (2015), 378–384.
Eibensteiner, F., Laml-Wallner, G., Thanhaeuser, M., Ristl, R., Ely, S., Jilma, B., et al. ELBW infants receive inadvertent sodium load above the recommended intake. Pediatr Res 88:3 (2020), 412–420.
Makela, P.M., Immeli, L., Leskinen, M., Rinta-Koski, O.P., Sund, R., Andersson, S., et al. Hidden sources like saline flushes make a significant contribution to the fluid intake of very low birthweight infants during the first postnatal week. Acta Paediatr 109:4 (2020), 688–696.
