Evaluation of Efficacy and Safety of Premixed Parenteral Nutrition versus Customized Parenteral Nutrition in a Large Teaching Hospital

Abstract

In the last two decades, there has been a significant degree of controversy surrounding the use of standardized parenteral solutions. Opponents of standardized parenteral nutrition claim that individualized parenteral nutrition is necessary because the critically ill patient requires daily manipulation of macro-and micro-nutrients secondary to stress associated with complex ailments. The purpose of this study was to determine if premixed parenteral nutrition solutions were equally safe and efficacious, while being less costly, in managing parenteral nutrition of patients at a large metropolitan teaching hospital, as compared to customized parenteral nutrition solutions. This was a randomized controlled trial with no placebo involving 100 patients requiring central parenteral nutrition. Consenting patients received either customized parenteral nutrition or premixed double chamber parenteral nutrition containing protein, carbohydrates and electrolytes. Vitamins and trace elements were added as needed. Each subject enrolled in the study was followed until the parenteral nutrition was either discontinued, the patient was transferred from the facility, or the patient expired during the study. Premixed and customized parenteral nutrition solutions were shown to be equally efficacious in patients as their blood glucose, fluid status, nutritional markers, serum electrolytes, phosphate, and magnesium values were within normal limits (p