Parenteral total nutrient mixture - Huaqiang Electronic Network

There are many types of nutrients supplied by parenteral nutrition. From a physiological point of view, it is most reasonable to mix various nutrients in a 3L Plastic bag (called a whole nutrient mixture). At the same time, various nutrients entering the body, each performing their duties, is beneficial to anabolism. In addition, high-concentration glucose can be diluted after mixing, and the osmotic pressure is lowered, making it possible to inject via peripheral vein. After infusion, the fat emulsion input per unit time is much lower than the single-bottle infusion of the fat emulsion, which avoids the side reaction caused by the fat emulsion infusion too fast. The whole nutrient mixture is formulated in a sterile environment. There is no need to vent and replace the infusion bottle during use. The fully enclosed infusion system greatly reduces the chance of contamination. The preparation process of the whole nutrient mixture should comply with the prescribed procedures and be handled by a special person to ensure that the physical and chemical properties of the fat emulsion in the mixture remain normal.

In the basic solution, various electrolyte solutions are added as appropriate according to the condition and blood biochemical examination. Since the body does not have a storage of water-soluble vitamins, the compound water-soluble vitamin injection should be supplemented in the parenteral nutrition solution. Short-term fasting people do not produce fat-soluble vitamins or trace element deficiency, so they only need to be supplemented for more than 2 to 3 weeks after fasting. The amount of regular insulin should be added to the solution (insulin: glucose = 1U: 8~10g).

The composition of the nutrient solution should be changed for various special patients. Diabetes should limit the amount of glucose and supplement the exogenous insulin to control blood sugar. The amount of fat emulsion can be increased to make up for the lack of energy. For patients with decompensated liver cirrhosis with abnormal liver function (blood bilirubin and elevated liver enzyme levels), the composition and dosage of parenteral nutrition solution should be greatly adjusted. At this time, the ability of the liver to synthesize and metabolize various nutrients is drastically reduced, so the amount of parenteral nutrient solution should be reduced (about 1/2 of the total amount). Adjustments should also be made in terms of nutritional punishment, including the use of amino acid solutions with high BCAA content and the use of fat emulsions with both L CT and MCT. In patients with significant hypoproteinemia, due to the limited ability of the liver to synthesize albumin, it is necessary to simultaneously supplement human albumin in order to correct hypoalbuminemia more quickly. In the nutrient solution of patients with renal failure, the dosage of glucose and fat emulsion is generally not limited, and the amino acid solution is often selected from amino acid which is mainly EAA. Unless dialysis conditions are available, the amount of water should be strictly limited.