• Mirtallo J, Canada T, Johnson D, Kumpf V, Petersen C, Sacks G, Seres D, Guenter P, Task Force for the Revision of Safe Practices for Parenteral Nutrition. Stability and compatibility of parenteral nutrition formulations. In: Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr 2004 Nov-Dec;28(6):S61-5. [12 references]

This is the current release of the guideline.

1. The dose, admixture preparation, packaging, delivery process, and storage and administration method should be confirmed to ensure that the parenteral nutrition (PN) is stable and all components are compatible.
2. The responsible pharmacist should verify that the administration of drugs with PN either admixed in the PN or co-infused through the same intravenous tubing is safe, clinically appropriate, stable, and free from incompatibilities.
3. If there is no information concerning compatibility of the medication with PN, it should be administered separately from the PN.
4. Compatibility information should be evaluated according to concentration of the medication used and whether the base formulation is a 2-in-1 or a total nutrient admixture (TNA).
5. Insulin use in PN should be done in a consistent manner according to a method that healthcare personnel have adequate knowledge.
6. Decisions related to stability and compatibility are made according to the most reliable information available from the literature or manufacturer of intravenous nutrients. If no information exists, stability and compatibility of the PN shall be determined in consultation with the manufacturer before it is dispensed to the patient.
7. Given the limited amount of published stability information available, the use of a 2-in-1 formulation with separate administration of intravenous fat emulsion (IVFE) is recommended for neonatal/infant patients.

None provided

The recommendations are supported by a review of the literature as well as results of the 2003 American Society for Parenteral and Enteral Nutrition Survey.

• Mirtallo J, Canada T, Johnson D, Kumpf V, Petersen C, Sacks G, Seres D, Guenter P, Task Force for the Revision of Safe Practices for Parenteral Nutrition. Stability and compatibility of parenteral nutrition formulations. In: Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr 2004 Nov-Dec;28(6):S61-5. [12 references]

Not applicable: The guideline was not adapted from another source.

2004 Dec

American Society for Parenteral and Enteral Nutrition - Professional Association

American Society for Parenteral and Enteral Nutrition

Task Force for the Revision of Safe Practices for Parenteral Nutrition

Task Force Members: Jay Mirtallo, MS, RPh, BCNSP, Chair; Todd Canada, PharmD, BCNSP; Deborah Johnson, MS, RN; Vanessa Kumpf, PharmD, BCNSP; Craig Petersen, RD, CNSD; Gordon Sacks, PharmD, BCNSP; David Seres, MD, CNSP; Peggi Guenter, PhD, RN, CNSN

Not stated

This is the current release of the guideline.

This NGC summary was completed by ECRI Institute on July 8, 2008. The information was verified by the guideline developer on July 30, 2008.

This NGC summary is based on the original guideline, which is subject to the guideline developer's copyright restrictions. Reprint request/permissions should be sent to: Permissions Department, ASPEN; 8630 Fenton St. #412; Silver Spring, MD 20910; Fax: 301-587-2365.