Parenteral nutrition (PN) Intravenous for Adults (Kabi) (FRIDGE PREPARATION)

Who can administer

May be administered by registered competent doctor or nurse/midwife

Not routinely stocked in GUH- must be discussed between Dietietics and Pharmacy on an individual patient basis
A terminal FILTER should be used for all patients receiving parenteral nutrition. Unless otherwise instructed by the dieticians use a 1.2micron Intrapur Braun filter REF 4099702. ORDER from SURGICAL STORES ITEM CODE FTC326 (Updated 3 Dec 2024)
Strict aseptic technique is vital when preparing PN - use a clean trolley with a sterile surgical sheet
A DEDICATED CVC lumen must be used
Excessively fast administration rate can lead to nausea, vomiting, shivering and electrolyte disturbances
PN must be prescribed on the drug kardex
Addition of electrolytes can be fatal, DO NOT add unless on written advice of an experienced PN pharmacist

	Kabi 6c	Kabi 8C	Kabi 11C	Kabi 19C	Kabi 25C (fat free)	Kabi 5C
Route of administration	Central line	Central line	Central line	Central line	Central line	Central line
	Content per bag	Content per bag	Content per bag	Content per bag	Content per bag	Content per bag
Total bag volume	2000ml	2000ml	2302ml	1000ml	2000ml	1536ml
Nitrogen (g)	15	18	18	11	15	9
Amino acids (g)	87.5	105.1	105.1	64.2	87.5	52.5
Total calories (kcal)	2211	1731	2211	1278	1950	1521
Non-protein calories (kcal)	1861	1311	1791	1021	1600	1311
Glucose calories (kcal)	1000	800	1060	500	1600	800
Lipid calories (kcal)	861	511	731	521	nil	511
Non-protein calories/nitrogen ratio (kcal/g N)	124	73	99.5	93	107	147.5
Sodium (mmol)	80	60	84.3	40	72	72
Potassium (mmol)	80	80	84	40	60	10
Magnesium (mmol)	12	12	12.2	5	5	1.5
Calcium (mmol)	5	5	7	2.5	5	5
Phosphate (mmol) (inclusive of SMOFLipid and Vitlipid)	27.7	30	25	15	25	7.7
Acetate (mmol) (from Aminoven 25)	87.6	105	105	66.5	87.6	52.53
Chloride (mmol)	127	97	142.3	62	92	83.39
pH	no data	no data	no data	no data	no data	no data
Osmolarity (mOsm/L)(approx)	1374	1274	1302	1596	1678	1255

Continuous intravenous infusion (administer using an electronically controlled infusion device)

Administer at a rate specified by dietitican - via Central Line only for regimens with 'C' in regimen name, e.g. Kabi 5C, 6C, 8C, 11C, 19C, 25C

1: Normal dose

The dose and rate of administration varies - consult dietician for guidance for each individual patient
Normally the rate is increased gradually during the first 24 to 48 hours, and is then adjusted depending on total volume to be given and the time over which it is to be administered

Monitor water and electrolyte balance, serum osmolarity, trigylcerides, acid/base balance, blood glucose, U&E's and LFT's throughout treatment
Serum triglyceride concentrations must be checked twice weekly - see Parenteral Nutrition guidelines 2015 (Q pulse: CLN-DIET-054)

Allergens: Egg protein, fish, soya, nuts - contact pharmacy for further details
Other formulations: are available if requested by the Nutrition Department
Erroneous information supplied by manufacturer yet to be confirmed in writing (*C non-protein energy 1321 kcal not 1311)

Light protection recommended when in use - Red plastic covers provided
Store in refrigerator
If the bag has been out of the refrigerator for more than 2 hours- it must be discarded
If it has been out of the refrigerator for less than 2 hours before hanging- it may be put back into the fridge
Do not freeze

(1) Data on file from Kabi November 2017(2) Communication with Dietetics Department UHG

Intravenous nutrition