Department of Pharmacy, National Taiwan University Hospital, Taipei, Taiwan.
Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
Pediatr Neonatol. 2020 Jun;61(3):331-337. doi: 10.1016/j.pedneo.2020.02.004. Epub 2020 Feb 22.
Preterm infants require higher calcium and phosphate intake than term infants to facilitate adequate bone growth, but this is rarely met in parenteral nutrition (PN) solution because of the limited solubility of calcium and phosphate. This study aimed to evaluate the solubility of organic phosphate with calcium gluconate in neonatal PN solutions, simulating its clinical use.
PN solutions were composed of calcium gluconate at 50 mEq/L and sodium glycerophosphate (NaGP) at 25 mmol/L. Another component included 1% or 4% amino acid and 10% or 20% dextrose. For comparison, PN solution composed of potassium phosphate was also evaluated. Each solution was evaluated using the following methods: visual inspection, light obscuration particle count test, and pH measurement. To simulate the clinical condition, the solution was tested after compounding, after being stored at 25 °C for 24 h, and after being stored at 2°C-8°C for 2 or 9 days and subsequently at 25 °C for 24 h.
There was no visual deposition in PN solution using NaGP in any of the concentrations and under any stored condition. The solution fulfilled the criteria of physical compatibility as < 25 particles/mL measuring ≥10 μm in diameter and <3 particles/mL measuring ≥25 μm in diameter. On the contrary, visual deposition was evidently noted in PN solution using potassium phosphate after its formulation, and the particle count significantly exceeded the range of physical compatibility.
NaGP and calcium gluconate have significantly good compatibility in PN solution. The use of NaGP in neonatal PN prevents calcium and phosphorus precipitation, hence increasing their supply to preterm infants in meeting their growth requirement.
早产儿需要比足月儿更高的钙和磷摄入量，以促进骨骼充分生长，但由于钙和磷的溶解度有限，在肠外营养（PN）溶液中很少能满足这一需求。本研究旨在评估葡萄糖酸钙与甘油磷酸钠（NaGP）结合在新生儿 PN 溶液中的溶解度，模拟其临床应用。
PN 溶液由 50 mEq/L 的葡萄糖酸钙和 25 mmol/L 的 NaGP 组成。另一个成分包括 1%或 4%的氨基酸和 10%或 20%的葡萄糖。为了进行比较，还评估了含有磷酸钾的 PN 溶液。使用以下方法评估每种溶液：目视检查、光浊度粒子计数测试和 pH 值测量。为了模拟临床情况，在配制后、在 25°C 下储存 24 小时后、在 2°C-8°C 下储存 2 天或 9 天然后在 25°C 下储存 24 小时后对溶液进行测试。
在任何浓度和任何储存条件下，使用 NaGP 的 PN 溶液均无可见沉淀物。该溶液符合物理相容性标准，即直径≥10 μm的粒子<25 个/mL，直径≥25 μm的粒子<3 个/mL。相反，在用钾磷酸盐配制后的 PN 溶液中明显观察到可见沉淀，粒子计数明显超过物理相容性范围。
NaGP 和葡萄糖酸钙在 PN 溶液中有很好的相容性。在新生儿 PN 中使用 NaGP 可防止钙和磷沉淀，从而增加早产儿对钙和磷的供应，以满足其生长需求。
