Keeping the calcium:phosphorus solubility product ... - RM Solutions

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Calcium and Phosphate • Preterm infants, children born before 37 weeks of pregnancy, are the major recipients of parenteral nutrition therapy. • Preterm infants frequently intolerant to enteral feeding due to anatomic and functional immaturity of the digestive tract, added to other clinical conditions that affect cardiovascular function in the preterm post-natal life [1,2,3] 1. Philip AGS. Pediatr Res 2005, 58, 799=815. 2. Fanaro S, Cristofori G, Mosca F, Savino F, Vigi V. Acta Paediatr Suppl 2005, 94, 75-63. 3. Kalhan CS, Iben S: Clin Perinatol 2000, 27:23-55.
• These patients need a Ca/PO 4 ratio higher than 1 (42 mg/Kg/d Ca and 36 mg/Kg/d P) in order to allow bone mineralization. • Studies on calcium and phosphorus retention in neonates propose that 1.7/1 (75 mg/Kg/d Ca and 45 mg/Kg/d P) calcium/phosphorus ratio is closer to that observed for intrauterine life, allowing greater retention of these ions (1) • This ratio is difficult to obtain with parenteral feeding, because the availability of these ions offer is limited by their salts solubility in the formulation (2) . 1. Devlieger H, etal. E. Clin Nutr 1993, 12, 277-281. 2. Rigo J, Senterre J: Nutritional needs of premature infants: current issues. J Pediatr 2006, 149:S80-S88.
Page 1: Parenteral Nutrition Formulations:
Page 4 and 5: Pharmacist Responsibilities cont.
Page 6 and 7: Parenteral Nutrition Prescriptions
Page 10 and 11: Depiction of dibasic calcium phosph
Page 12 and 13: Factors affecting TPN Compatibility
Page 14 and 15: pH Effects • The pH of the final
Page 16 and 17: • Since the eye can only detect p
Page 18 and 19: • TPN is a potential source of ox
Page 20 and 21: • Fat sources used in the manufac
Page 22 and 23: • Concerns for the potential of l
Page 24 and 25: Osmolarity: The Big Question? • O
Page 26 and 27: Peroxide Formation • It has been
Page 28 and 29: • The physical stability of the l
Page 30 and 31: Mixing: 3 in 1 vs 2 in 1? Advantage
Page 32 and 33: • Less nursing time needed for 1
Page 34 and 35: • Less attractive in pediatric se
Page 36 and 37: The calcium/phosphorus ratios for P
Page 38 and 39: Osmolarity (mOsm/L) = [(grams dextr
Page 40 and 41: Review of Access Devices Used for N
Page 42: Factors which affect the formation

Keeping the calcium:phosphorus solubility product ... - RM Solutions

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