Pharmacy, Geneva University Hospitals, Geneva, Switzerland.
JPEN J Parenter Enteral Nutr. 2010 Sep-Oct;34(5):542-5. doi: 10.1177/0148607110374615.
The provision of high amounts of calcium and phosphate in parenteral nutrition (PN) solution for neonates is important for bone mass accretion. Because of the risk of calcium phosphate precipitation, a well-documented incompatibility for inorganic salts, the concentrations of these electrolytes in PN are generally limited to 5 mmol/L. The aim of this study was to assess the risk of precipitation of calcium phosphate when organic calcium and phosphate salts are used instead of inorganic salts.
Precipitation curves were determined for inorganic and organic calcium and phosphate salts in a PN solution favorable to precipitation (low concentration of amino acids and glucose) using visual inspection and particle counts.
The use of organic phosphate salt was associated with a decreased risk of precipitation of calcium phosphate. No precipitation occurred up to a concentration of 50 mmol/L of calcium and phosphate. In contrast, organic calcium salt only slightly decreased the risk of precipitation.
Up to 50 mmol/L of organic calcium and phosphate salts can be safely mixed in PN, even in unstable conditions, making it possible to follow the current European recommendations for requirements in neonates.
新生儿肠外营养（PN）溶液中提供大量的钙和磷酸盐对于骨量积累很重要。由于存在钙磷酸盐沉淀的风险，这是无机盐的一个已知的不相容性，因此 PN 中这些电解质的浓度通常限制在 5mmol/L。本研究旨在评估使用有机钙和磷酸盐盐代替无机盐时发生钙磷酸盐沉淀的风险。
使用有利于沉淀的 PN 溶液（氨基酸和葡萄糖浓度低），通过目视检查和颗粒计数来确定无机和有机钙和磷酸盐盐的沉淀曲线。
使用有机磷酸盐盐与降低钙磷酸盐沉淀的风险相关。钙和磷酸盐的浓度高达 50mmol/L 时不会发生沉淀。相比之下，有机钙盐仅略微降低了沉淀的风险。
即使在不稳定的条件下，PN 中也可以安全地混合高达 50mmol/L 的有机钙和磷酸盐盐，这使得可以遵循当前欧洲对新生儿需求的建议。
