Abstract
Background. Parenteral route is accepted for delivering nutrition when enteral feeding is not possible. Standardized premixed parenteral nutrition solution (SPNS) formulations are uniform in their characteristics and can be chosen based on the same nutrient calculations. We compared the feasibility of administering SPNS as an alternative to customized parenteral nutrition solution (CPNS) and calculate its cost implications. Methods. Retrospective review of 47 patients receiving CPNS at a tertiary care hospital ICU was performed and compared with SPNS formulations. The amounts of macro- and micronutrients (days 1, 3, 5, 7) were recorded and averaged to 2000-mL bag. These data were compared with the available premixed formulations and percentage differences were calculated. The costs and manpower for CPNS were obtained from our institutional central pharmacy. Results. The percentage difference for carbohydrates and proteins ranged from −1.0% to 2.9% and 5.8% to 9.0% with an average of 0.8% and 7.0%, respectively across all days. Since premixed micronutrients were only available in one formula, they were not easily comparable. The cost analysis showed an average savings of approximately $130 per parenteral nutrition bag. Conclusions. While macronutrients are quite comparable between formulations, any required micronutrients should be managed individually. SPNS has potential cost savings compared with CPNS when applied in the right setting.
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