Smith Brian S, Kothari Hema, Hayes Bryan D, Tataronis Gary, Hudlin Margaret, Doole John, Hartman Christian
Department of Critical Care Surgery, UMass Memorial Medical Center, Worcester, MA 01655, USA.
Am J Health Syst Pharm. 2007 Apr 1;64(7):730-9. doi: 10.2146/ajhp060163.
The quantity of aluminum in common ingredients used to compound parenteral nutrient (PN) solutions was calculated to quantify the actual aluminum content, and opportunities to modify the aluminum content by changing the manufacturer of the ingredients were explored.
A retrospective evaluation of a random sample of 10 neonatal, 10 pediatric, and 10 adult patients who received PN solutions was performed to quantify the aluminum content in these solutions on the basis of the ingredients used at the authors' institution. A recalculation was performed using the lowest aluminumcontaining ingredients to determine the potential for aluminum minimization in each PN solution.
Various manufacturers produce each ingredient required to make PN solutions. Significant variation exists among manufacturers, vial size, and concentrations. Statistically significant differences in the mean aluminum content of PN solutions before and after aluminum minimization were found to exist within each sample of patients. Among the neonatal PN solutions, aluminum content was significantly reduced from a mean +/- S.D. of 84.16 +/- 47.61 to 33.6 +/- 16.69 mug/kg/day. The pediatric PN solutions had a significant decline in aluminum content from a mean +/- S.D. of 16.24 +/- 3.66 to 6.84 +/- 2.66 mug/kg/day. Aluminum content in the high-risk adult PN solutions significantly decreased from a mean +/- S.D. of 4.58 +/- 2.06 to 2.31 +/- 0.63 mug/kg/day.
There is wide variability in the aluminum concentration of injectable products used in the compounding of PN solutions. Selecting products with low aluminum concentration may substantially reduce the amount of the element administered to patients.
计算用于配制肠外营养（PN）溶液的常见成分中的铝含量，以量化实际铝含量，并探索通过更换成分制造商来改变铝含量的机会。
对10例接受PN溶液的新生儿、10例儿科患者和10例成人患者的随机样本进行回顾性评估，根据作者所在机构使用的成分来量化这些溶液中的铝含量。使用铝含量最低的成分进行重新计算，以确定每种PN溶液中铝含量最小化的潜力。
各种制造商生产配制PN溶液所需的每种成分。制造商、小瓶尺寸和浓度之间存在显著差异。在每个患者样本中，发现铝含量最小化前后PN溶液的平均铝含量存在统计学显著差异。在新生儿PN溶液中，铝含量从平均±标准差84.16±47.61显著降低至33.6±16.69μg/kg/天。儿科PN溶液的铝含量从平均±标准差16.24±3.66显著下降至6.84±2.66μg/kg/天。高风险成人PN溶液中的铝含量从平均±标准差4.58±2.06显著降至2.31±0.63μg/kg/天。
用于配制PN溶液的注射产品的铝浓度存在很大差异。选择铝浓度低的产品可能会大幅减少给予患者的该元素量。
