What cutoff range of osmolarity do institutions out there use when switching from central route to peripheral route? (What is the maximum osmolarity allowed for peripheral infusion of TPN in a neonate?).

We use the same TPN solutions regardless if we admin it in a peripheral catheter or a central line (although we mainly use central lines).

Will check with our pharmacy tomorrow about our osmolarity limits. The hospital pharmacy prepares all our TPN, am not updated.

Asked the pharmacist in charge of TPN at the Karolinska hospital pharmacy about this topic.

The computer-aided mixing of the various components, does not take osmolarity into account... at all. In other words, we do not have osmolarity limits and we do not know about the osmolarity in our TPN solutions...

Clearly, we could learn something here, will follow further posts in this thread with great interest!

Dear all

I agree with Stefan that either using central or peripheral lines, we don't "care" about osmolarity of TPN; however, and this is our policy in casablanca, we manage to keep that, as I was learned by my instructors in France during my training, between 280-320 mosmol/l.This seems to fit the renal capacity at this age.

Hope this help you.

Best regards

I checked around with some other large hospitals, it seems it varies by institution. Some hospitals cutoff is 900 mosmoles/L for peripheral infusion, others go as high as 1200 mosmoles/L.

We use 800-850mosm/L as highest osmolarity for peripheral infusion and up to 1800mosm/L for central lines

Osmolarity limits seem to vary among institutions, we just developed a policy here limiting peripheral infusions to 950 mOsmol/L.

Hi

we calculate osmolarity for every TPN-solution (we means a self constructed of our pharmacologist) whether used peripherilly or central. Max 800 mosml/l for periphery.

Hi

we calculate osmolarity for central or peripheric solution and we try usually to make it inferior to some limits (300 mosmol/l for the peripheric one and 800 for central one).

In our unit, the maxim osmolaridad peripheric is 900 mosm/l and the central route is a 1500 mosm/l.

Pablo Velásquez Acosta

LIma-Peru