TPN

canned_bread · Jul 6, 2012

Yes. It comes from pharmacy in a silver bag, and stays that way. Only when checking it (such as prior to hanging, new shift etc) do we lift up bag and read label. Outside on the bag it states TPN.

NICU_babyRN, BSN, RN · Jul 6, 2012

We sure do. although, let's face it. we protect only the bag. Not the tubing. So does it really make a difference?

missnurse01, MSN, RN · Jul 7, 2012

okay,

we have no idea here in CVICU why you all protect TPN-does it have to do with different percentages make it more susceptible to degradation or something?

thanks

karnicurnc, MSN, APRN, CNS · Jul 7, 2012

We do not protect TPN from light and I am very curious and interested to find out why one should and if this is best practice.

umcRN, BSN, RN · Jul 8, 2012

I was told that light can break down some of the proteins...but I never actually looked into this so I don't know if it's true or not

Also all the units in my hospital keep the TPN in the bag it came in, not just the NICU so whatever the reason it's a whole hospital policy

**edit**

Just found some research that says vitamins are light sensitive and can become unstable and broken down when exposed to light. However there were also some studies that showed no differences between TPN that was protected from light and TPN that was not protected.

NicuGal, MSN, RN · Jul 8, 2012

We don't cover ours. I believe they did a study at our hospital on this, and we work with one of the top neonatal nutritionists in the country.

missnurse01, MSN, RN · Jul 10, 2012

been a nurse for 15 years, and work with those that have been for over 30, and no one has ever protected their tpn. interesting!

Mimi2RN, ASN, RN · Jul 12, 2012

We don't since we no longer have Multivits in the TPN.

Bortaz, MSN, RN · Jul 13, 2012

We do not.

canned_bread · Jul 13, 2012

Firstly, I looked on a bag of TPN after this post, and it states on the bag provided by the manufacturer (which then the pharmacy has added to it extra nutrients the child required) that the TPN is to be protected from light.

I found articles (2001) that states it SHOULD be protected: Protecting TPN and lipid infusions from light:... [Neonatal Netw. 2001] - PubMed - NCBI

Total parenteral nutrition-associated alteration... [Pediatr Res. 1993] - PubMed - NCBI

This study shows its makes no difference: Shielding Parenteral Nutrition From Light: Does the Available Evidence Support a Randomized, Controlled Trial?

Those studies were just from a quick google... it's hard when they are all reputable yet conflicting!

luvsnicu · Aug 13, 2012

We cover our NVN and lipid bags and use amber tubing. We used to do it for all kiddos, but now just those born under 30-weeks. I guess there was some research to show that the light broke down some of the proteins or vitamins (something like that) and that it could increase risk of BPD.