Mélanges industriels de nutrition parentérale en pédiatrie : faisabilité en nutrition parentérale à domicile

Objective. - Evaluate the substitution of tailor-made parenteral nutrition admixtures by industrial premixed bags for children in home parenteral nutrition. Methods. - A retrospective study of patients' formulations was carried out under three successive criteria: ratio of non-protein calories per volume, calorie to nitrogen ratio, electrolyte concentration. Then a comparison with industrial products available on the French market was done. Results. - Formulations of 29 industrial multichambered bags were compared with 37 pediatric prescriptions of home parenteral nutrition. The percentages of patients for whom the use of an industrial bag was possible decreased during the analysis: 84% patients after application of the first criterion, 41% after the second test and 22% after the last criterion. For these patients, the maximum number of substitution possibilities also declined during the study (12 to 1 bags). The problem with the small volume of selected industrial premixed bags appears when considering the administration of 2 to 9 bags by day to the patient. Conclusion. - The diversity and complexity of pediatric parenteral nutrition formulas makes the use of industrial admixtures difficult for qualitative and organizational reasons. So far, a tailor-made admixture remains the most child-friendly pediatric parenteral nutrition at home. (C) 2013 Published by Elsevier Masson SAS.