Chris van den Akker

May I ask whether anyone has experience with a prolonged hanging time of a parenteral nutrition (PN) bag (incl lipids) of up to 48h? We are probably changing our PN regimen into an all-in-one bag. Since the bag contains >400 mL, it would suffice for most premature infants for 2 days. One strategy could thus be to prolong hang time from 24h to 48h to cut PN costs by half. A recent Australian study (attached) also suggests this would be a feasible approach: https://www.ncbi.nlm.nih.gov/pubmed/23320598 Since our pharmacy will do all additions to the bag in an aseptic environment, including connection and filling the line, I think it could be an attractive solution. Also there is an air-filled dripping chamber in the line, so there exists no continuous fluid-filled connection from the patient to the PN-bag. On the other hand, the line would be in place for 48h as well, so this could form a potential risk. We must be sure it is a safe approach though… What are your thoughts and experiences on this matter? Thank you so much, best wishes, Chris van den Akker, neonatologist Amsterdam UMC, the Netherlands

The NeoMate app is very helpful! There is an infusion calculator, where you can easily 'calculate' how much medication needs to go in the syringe, with how much glucose/saline, and at which rate the pump then needs to run. https://london-nts.nhs.uk/professionals/neomate-mobile-app/