Ochoa-Sangrador C, Brezmes-Valdivieso M F, Gil-Valiño C
Servicio de Pediatría, Hospital Virgen de la Concha, Zamora, Spain.
Comput Biomed Res. 1995 Aug;28(4):271-81. doi: 10.1006/cbmr.1995.1018.
The formulation and elaboration of a correct parenteral nutrition (PN) in infancy requires the use of many parameters, the realization of complicated mathematical calculations, and repeated and individualized adjustments of the final constituents. The use of computer programs in the confection of PN has simplified the whole process, but, to our understanding, the programs being used at the moment lack the flexibility needed to generalize its use in the pediatric age. The aim of this work is to present a new computer program able to make up complete pediatric units of PN by itself, which follow the nutritional requirements and the marketed preparations established for each clinical situation. The program provides, automatically, standard amounts for each nutrient, according to age, water needs, and route of administration. The program turns these amounts, which can be modified before or after knowing the final composition, into milliliters of each commercial product and provides a complete analysis of the PN solution. It is also possible to adapt the basic configuration of the program to the needs of each patient, modifying the nutritional requirements and the products that the program will use. In order to assess the validity of the program, we made up a series of PN solutions, for a simulated sample of patients, which represented different clinical situations and age groups. We analyzed the composition of the mixtures and its physical-chemical stability. No problems in the PN solutions generated by the program when using our standard configuration were found. A study of reproducibility was carried out and no difficulties of execution, errors, or differences in the composition of the PN solutions designed by the different physicians were found. Average time needed for the design of a PN was less than 5 min. The use of computer programs in the design of mixtures of PN reduces errors and time, allowing a better use of this technique of nutritional support.
制定和精心调配正确的婴儿肠外营养（PN）需要使用许多参数，进行复杂的数学计算，并对最终成分进行反复且个性化的调整。在配制PN时使用计算机程序简化了整个过程，但据我们了解，目前使用的程序缺乏将其在儿科广泛应用所需的灵活性。这项工作的目的是展示一种新的计算机程序，它能够自行组成完整的儿科PN单位，遵循针对每种临床情况确定的营养需求和市售制剂。该程序会根据年龄、水需求和给药途径自动提供每种营养素的标准量。该程序将这些量（在知晓最终成分之前或之后均可修改）换算为每种市售产品的毫升数，并对PN溶液进行全面分析。还可以根据每个患者的需求调整程序的基本配置，修改营养需求以及程序将使用的产品。为了评估该程序的有效性，我们针对模拟的患者样本配制了一系列PN溶液，这些样本代表不同的临床情况和年龄组。我们分析了混合物的成分及其物理化学稳定性。使用我们的标准配置时，未发现该程序生成的PN溶液存在问题。我们进行了重复性研究，未发现不同医生设计的PN溶液在执行上有困难、存在误差或成分有差异。设计一个PN所需的平均时间不到5分钟。在PN混合物设计中使用计算机程序可减少误差和时间，使这种营养支持技术得到更好的应用。
