bisiegel

IVRUS, let me take it from another angle. The final dextrose concentration in a TPN usually range 10%- 20 %. It is NEVER 50 to 70 %. It is compounded from a stock of 50% or 70 % and further diluted. In my opinion anything more than than 20% cals coming from glucose should be examined to see if caloric intake could be shifted towards the aminos or the fats. The final osmolarity is very high in the TPN due to the solute additive effects of all of the ingredients except for the sterile water. The amino acids and electrolytes and the dextrose toegether make the final osmolarity and yes it most always exceeds the 600s and more typically in the 1000 - 1100 range and hence the necessity of a central access device. Does that make sense ? ~ Barry

IVRUS, without referencing this statement I will rely on my years as aRPh who has worked with TPN a little. the stock concentrations of dextrose are either 50 or 70 but it gets diluted with the other main Fluids the amino acids the sterile water and lytes. So a 200 gm dextrose load giving 680 calories from Dextrose would use 140 ml of a70 percent solution at the compounding station.once the other Ingredients are added 200 gm is in final volume for example 2liter which makes final concentration 10 percent. For the final concentration to be the 50 to 70 above stated would be pure stock concentration .also ped tpn is a sub specialty and much thought goes into its preparation. Ped tpn usually is done with Many considerations that the adult tpn formulator would not consider. Please excuse the copy From my droid, cheers.hY

Hi, I wanted to add that Lipids need not to exceed recommended infusion rates under normal circumstances i.e. nutrition indications. In lipid rescue of anathesia toxicity this would not apply. Also lipids are lovely places for germs to grow in and anything seemingly chunky should NOT be used.