Schmidt G L, Baumgartner T G, Fischlschweiger W, Sitren H S, Thakker K M, Cerda J J
JPEN J Parenter Enteral Nutr. 1986 Mar-Apr;10(2):203-7. doi: 10.1177/0148607186010002203.
The purpose of this study was to determine if (1) the calcium/phosphate insoluble product was inversely related to pH [when cysteine HC1 (CH) was added as neonatal supplementation at 0.5 mM/kg/day to hyperalimentation (HAL) solutions] and (2) the potential cost savings to the hospital. The pH of the HAL solutions was adjusted by adding various amounts of CH to the HAL solution. HAL solutions containing 27 mEq of calcium/liter and 30 mEq (15 mM) of phosphate/liter were compounded. Ten-milliliter aliquots were analyzed at 0, 12, 24, and 48 hr. All samples (n = 56) were filtered (0.22 mu), viewed with 7-10,000 X magnification scanning electron microscopy, and qualitatively analyzed with a Philips Energy Dispersive X-Ray Analysis System equipped with a SW9100 Microprocessor. Calcium/phosphate insoluble product was present in the 0-, 12-, 24-, and 48-hr samples from the CH-free solutions. The solutions containing 759 mg (4.17 mM)/liter of CH however, remained free of precipitant. This investigation demonstrated that addition of CH to HAL can foster significant cost containment (projected $82,000/yr tangible hospital savings) by the elimination of current calcium/phosphate separation procedures for neonates on parenteral nutrition.
（1）（当以0.5 mM/kg/天的剂量将半胱氨酸盐酸盐（CH）作为新生儿补充剂添加到全胃肠外营养（HAL）溶液中时）钙/磷酸盐不溶性产物是否与pH呈负相关；以及（2）对医院潜在的成本节约情况。通过向HAL溶液中添加不同量的CH来调节HAL溶液的pH值。配制每升含27 mEq钙和30 mEq（15 mM）磷酸盐的HAL溶液。在0、12、24和48小时对10毫升等分试样进行分析。所有样品（n = 56）均经过过滤（0.22μm），用7 - 10000倍放大倍数的扫描电子显微镜观察，并用配备SW9100微处理器的飞利浦能量色散X射线分析系统进行定性分析。无CH溶液在0小时、12小时、24小时和48小时的样品中存在钙/磷酸盐不溶性产物。然而，每升含有759 mg（4.17 mM）CH的溶液仍无沉淀。本研究表明，向HAL溶液中添加CH可通过消除目前用于接受肠外营养的新生儿的钙/磷酸盐分离程序，显著降低成本（预计每年为医院节省82,000美元的实际费用）。
