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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 NOTE programme (collaboration between ESPR and University of Southampton) are opening a Pharmacology module in June, led by Karl Allegaert and Sinno Simons, using virtual/remote teaching. More information in attachment and via link below 🙂 https://www.espr.eu/news/news-detail/e-learning-neonatology-paediatrics/186 Proposal NOTE module DINA4 v3 (1).pdf
Hello 99ers, In Canada, very few hospitals are using probiotics so far. We started almost 18 months ago, using the protocol from Dr. Keith Barrington's group. The product that we use is called "FloraBaby ®". At this point, the RNs receive a jar per baby, and on the benchtop where they do regular medication preparation, they place the jar on a paper towel, don sterile gloves, measure out the 0.5 g of powder, and mix it once daily with the baby's feed, then recap the jar & throw out the gloves and paper. That's it. Does anyone have a better idea on how to deal with live organisms? Do any countries who have been using probiotics for many years have a guideline on how these products should be safely dispensed, eg. Japan? Another hospital in our province will be starting to use probiotics in their nursery shortly, and what I've heard is that they will have pharmacy make up individual doses in a laminar air flow hood in the pharmacy. The tech doing that would presumably be gowned, masked, gloved etc. full battle gear. Thanks for your thoughts, Connie Harris, Pharm.D neonatal pharmacist, Victoria, B.C., Canada