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Robert K Huston - One of the best experts on this subject based on the ideXlab platform.
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calcium chloride and calcium gluconate in neonatal parenteral nutrition solutions without cysteine compatibility studies using laser light obscuration methodology
Nutrients, 2018Co-Authors: Robert K Huston, J M Christensen, S M Alsharhani, Sumeia M Mohamed, Carl F HeiselAbstract:There are no compatibility studies for neonatal parenteral nutrition solutions without cysteine containing calcium chloride or calcium gluconate using light obscuration as recommended by the United States Pharmacopeia (USP). The purpose of this study was to do compatibility testing for solutions containing calcium chloride and calcium gluconate without cysteine. Solutions of Trophamine and Premasol (2.5% amino acids), containing calcium chloride or calcium gluconate were compounded without cysteine. Solutions were analyzed for particle counts using light obscuration. Maximum concentrations tested were 15 mmol/L of calcium and 12.5 mmol/L of phosphate. If the average particle count of three replicates exceeded USP guidelines, the solution was determined to be incompatible. This study found that 12.5 and 10 mmol/L of calcium and phosphate, respectively, are compatible in neonatal parenteral nutrition solutions compounded with 2.5% amino acids of either Trophamine or Premasol. There did not appear to be significant differences in compatibility for solutions containing Trophamine or Premasol when solutions were compounded with either CaCl2 or CaGlu-Pl. This study presents data in order to evaluate options for adding calcium and phosphate to neonatal parenteral nutrition solutions during shortages of calcium and cysteine.
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Calcium Chloride in Neonatal Parenteral Nutrition Solutions with and without Added Cysteine: Compatibility Studies Using Laser and Micro-Flow Imaging Methodology
PloS one, 2015Co-Authors: Robert K Huston, J M Christensen, Sumeia M Mohamed, Sara M. Clark, M. Alshahrani, Jeffrey A. NasonAbstract:Background Previous studies of compatibility of calcium chloride (CaCl2) and phosphates have not included particle counts in the range specified by the United States Pharmacopeia. Micro-flow imaging techniques have been shown to be comparable to light obscuration when determining particle count and size in pharmaceutical solutions. Objective The purpose of this study was to do compatibility testing for parenteral nutrition (PN) solutions containing CaCl2 using dynamic light scattering and micro-flow imaging techniques. Methods Solutions containing Trophamine (Braun Medical Inc, Irvine, CA), CaCl2, and sodium phosphate (NaPhos) were compounded with and without cysteine. All solutions contained standard additives to neonatal PN solutions including dextrose, trace metals, and electrolytes. Control solutions contained no calcium or phosphate. Solutions were analyzed for particle size and particle count. Means of Z-average particle size and particle counts of controls were determined. Study solutions were compared to controls and United States Pharmacopeia (USP) Chapter 788 guidelines. The maximum amount of Phos that was compatible in solutions that contained at least 10 mmol/L of Ca in 2.5% amino acids (AA) was determined. Compatibility of these solutions was verified by performing analyses of 5 repeats of these solutions. Microscopic analyses of the repeats were also performed. Results Amounts of CaCl2 and NaPhos that were compatible in solutions containing 1.5%, 2%, 2.5%, and 3% AA were determined. The maximum amount of NaPhos that could be added to Trophamine solutions of > = 2.5% AA containing at least 10 mmol/L of CaCl2 was 7.5 mmol/L. Adding 50 mg/dL of cysteine increased the amount of NaPhos that could be added to solutions containing 10 mmol/L of CaCl2 to 10 mmol/L. Conclusion Calcium chloride can be added to neonatal PN solutions containing NaPhos in concentrations that can potentially provide an intravenous intake of adequate amounts of calcium and phosphorus.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2: calcium chloride; NaPhos: sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2, calcium chloride; NaPhos, sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
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Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:Ca, calcium; CaCl2, calcium chloride; MFI, micro-flow imaging; Micro, microscopic; Phos, phosphate; SD, standard deviation; Z-Ave, Zetasizer Z-average particle diameter.aN = 5 for all groups.bOne mmol of elemental calcium equals 40 mg or 2 mEq.cParticle count per mL.Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
Evelyn A. Migaki - One of the best experts on this subject based on the ideXlab platform.
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Calcium Chloride in Neonatal Parenteral Nutrition: Compatibility Studies Using Laser Methodology
PloS one, 2014Co-Authors: Robert K Huston, J M Christensen, Sara M. Clark, Chanida Karnpracha, Jill E. Rosa, Evelyn A. MigakiAbstract:Introduction We have previously reported results of precipitation studies for neonatal parenteral nutrition solutions containing calcium chloride and sodium phosphate using visual methods to determine compatibility. The purpose of this study was to do further testing of compatibility for solutions containing calcium chloride using more sensitive methods. Methods Solutions of Trophamine (Braun Medical Inc, Irvine, CA) and Premasol (Baxter Pharmaceuticals, Deerfield, IL) were compounded with calcium chloride and potassium phosphate. Controls contained no calcium or phosphate. After incubation at 37° for 24 hours solutions without visual precipitation were analyzed to determine mean particle size using dynamic light scattering from a laser light source. Results Particle sizes were similar for control solutions and those without visual precipitation and a mean particle size
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable Without Precipitation at Various Trophamine and Potassium Phosphate Concentrations.
2014Co-Authors: Robert K Huston, Mark J. Christensen, Sara M. Clark, Chanida Karnpracha, Jill E. Rosa, Evelyn A. MigakiAbstract:CaCl2, calcium chloride; KPhos, potassium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable Without Precipitation at Various Trophamine and Potassium Phosphate Concentrations.
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calcium chloride and sodium phosphate in neonatal parenteral nutrition containing Trophamine precipitation studies and aluminum content
Journal of Parenteral and Enteral Nutrition, 2012Co-Authors: Evelyn A. Migaki, Brian J Melhart, Christina J Dewar, Robert K HustonAbstract:Objectives: The objectives were to determine concentrations of calcium chloride (CaCl) and sodium phosphate (NaPhos) that can be safely added to Trophamine-based parenteral nutrition (PN) and to measure aluminum (Al) concentrations in PN solutions containing CaCl and NaPhos vs those containing calcium gluconate (CaGlu) and potassium phosphate (KPhos). Methods: In study A, PN solutions containing varying amounts of Trophamine, CaCl, and NaPhos were compounded and then evaluated visually for precipitation. In study B, Al concentrations were measured in PN solutions containing CaCl and NaPhos (S1), CaGlu and NaPhos (S2), or CaGlu and KPhos (S3). Results: Study A showed that a maximum phosphorus concentration of 15 mmol/L could be added to a solution containing 12.5 mmol/L of calcium without evidence of precipitation when the amino acid (AA) concentration reached ≥3 g/dL (3%). In study B, the mean (range) Al concentrations were S1 = 2.2 (1.9–2.4), S2 = 8.5 (7.8–9.3), and S3 = 11.7 (10.8–12.2) µmol/L (means of...
Jeffrey A. Nason - One of the best experts on this subject based on the ideXlab platform.
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Calcium Chloride in Neonatal Parenteral Nutrition Solutions with and without Added Cysteine: Compatibility Studies Using Laser and Micro-Flow Imaging Methodology
PloS one, 2015Co-Authors: Robert K Huston, J M Christensen, Sumeia M Mohamed, Sara M. Clark, M. Alshahrani, Jeffrey A. NasonAbstract:Background Previous studies of compatibility of calcium chloride (CaCl2) and phosphates have not included particle counts in the range specified by the United States Pharmacopeia. Micro-flow imaging techniques have been shown to be comparable to light obscuration when determining particle count and size in pharmaceutical solutions. Objective The purpose of this study was to do compatibility testing for parenteral nutrition (PN) solutions containing CaCl2 using dynamic light scattering and micro-flow imaging techniques. Methods Solutions containing Trophamine (Braun Medical Inc, Irvine, CA), CaCl2, and sodium phosphate (NaPhos) were compounded with and without cysteine. All solutions contained standard additives to neonatal PN solutions including dextrose, trace metals, and electrolytes. Control solutions contained no calcium or phosphate. Solutions were analyzed for particle size and particle count. Means of Z-average particle size and particle counts of controls were determined. Study solutions were compared to controls and United States Pharmacopeia (USP) Chapter 788 guidelines. The maximum amount of Phos that was compatible in solutions that contained at least 10 mmol/L of Ca in 2.5% amino acids (AA) was determined. Compatibility of these solutions was verified by performing analyses of 5 repeats of these solutions. Microscopic analyses of the repeats were also performed. Results Amounts of CaCl2 and NaPhos that were compatible in solutions containing 1.5%, 2%, 2.5%, and 3% AA were determined. The maximum amount of NaPhos that could be added to Trophamine solutions of > = 2.5% AA containing at least 10 mmol/L of CaCl2 was 7.5 mmol/L. Adding 50 mg/dL of cysteine increased the amount of NaPhos that could be added to solutions containing 10 mmol/L of CaCl2 to 10 mmol/L. Conclusion Calcium chloride can be added to neonatal PN solutions containing NaPhos in concentrations that can potentially provide an intravenous intake of adequate amounts of calcium and phosphorus.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2: calcium chloride; NaPhos: sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2, calcium chloride; NaPhos, sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
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Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:Ca, calcium; CaCl2, calcium chloride; MFI, micro-flow imaging; Micro, microscopic; Phos, phosphate; SD, standard deviation; Z-Ave, Zetasizer Z-average particle diameter.aN = 5 for all groups.bOne mmol of elemental calcium equals 40 mg or 2 mEq.cParticle count per mL.Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
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Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate With Added Cysteine of 50 mg/dL (Mean±SD).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:Ca, calcium; CaCl2, calcium chloride; MFI, micro-flow imaging; Micro, microscopic; Phos, phosphate; SD, standard deviation; Z-Ave, Zetasizer Z-average particle diameter.aN = 5 for all groups.bOne mmol of elemental calcium equals 40 mg or 2 mEq.cParticle count per mL.Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate With Added Cysteine of 50 mg/dL (Mean±SD).
Maria Luisa Forchielli - One of the best experts on this subject based on the ideXlab platform.
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aminosyn pf or Trophamine which provides more protection from cholestasis associated with total parenteral nutrition
Journal of Pediatric Gastroenterology and Nutrition, 1995Co-Authors: Maria Luisa Forchielli, Kathleen M Gura, R SandlerAbstract:Cholestasis often occurs in infants on total parenteral nutrition (TPN) for long periods. Amino acid formulations developed specifically for infants, namely Aminosyn PF and Trophamine, may protect against cholestasis associated with total parenteral nutrition (CATPN). The development of cholestasis may also be caused by other risk factors such as prematurity, surgery, sepsis, and extracorporeal membrane oxygenation (ECMO). To evaluate the relative effectiveness of the pediatric amino acid formulations in reducing CATPN, the courses of 70 infants <1 year of age who received TPN for at least 14 days were reviewed. Cholestasis was defined as a conjugated serum bilirubin ≥2 mg/dl subsequent to the initiation of TPN ; CATPN was considered present when other factors related to cholestasis were ruled out. Liver function tests were recorded 24 h before starting TPN and at day 7, 15, and 21 during TPN infusion. Thirty infants (42.8%) developed cholestasis. CATPN was judged to have occurred in 15 (21.4%) of 70 infants, while 15 (21.4%) developed cholestasis secondary to other factors. Of the 15 CATPN patients, 7 had received Trophamine, 6 had received Aminosyn PF, and 2 had received both solutions. Aminosyn PF and Trophamine, along with other potential risk factors for CATPN such as antecedent surgery, sepsis, ECMO, prematurity, and nitrogen/calorie intake were analyzed by regression-analysis methods. None was statistically significant except the length of TPN (p = 0.0063). In conclusion, we cannot support the view that Trophamine is more effective than Aminosyn PF in the prevention of CATPN.
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Aminosyn PF or Trophamine: which provides more protection from cholestasis associated with total parenteral nutrition?
Journal of pediatric gastroenterology and nutrition, 1995Co-Authors: Maria Luisa Forchielli, Kathleen M Gura, Sandler RAbstract:Cholestasis often occurs in infants on total parenteral nutrition (TPN) for long periods. Amino acid formulations developed specifically for infants, namely Aminosyn PF and Trophamine, may protect against cholestasis associated with total parenteral nutrition (CATPN). The development of cholestasis may also be caused by other risk factors such as prematurity, surgery, sepsis, and extracorporeal membrane oxygenation (ECMO). To evaluate the relative effectiveness of the pediatric amino acid formulations in reducing CATPN, the courses of 70 infants
Sara M. Clark - One of the best experts on this subject based on the ideXlab platform.
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Calcium Chloride in Neonatal Parenteral Nutrition Solutions with and without Added Cysteine: Compatibility Studies Using Laser and Micro-Flow Imaging Methodology
PloS one, 2015Co-Authors: Robert K Huston, J M Christensen, Sumeia M Mohamed, Sara M. Clark, M. Alshahrani, Jeffrey A. NasonAbstract:Background Previous studies of compatibility of calcium chloride (CaCl2) and phosphates have not included particle counts in the range specified by the United States Pharmacopeia. Micro-flow imaging techniques have been shown to be comparable to light obscuration when determining particle count and size in pharmaceutical solutions. Objective The purpose of this study was to do compatibility testing for parenteral nutrition (PN) solutions containing CaCl2 using dynamic light scattering and micro-flow imaging techniques. Methods Solutions containing Trophamine (Braun Medical Inc, Irvine, CA), CaCl2, and sodium phosphate (NaPhos) were compounded with and without cysteine. All solutions contained standard additives to neonatal PN solutions including dextrose, trace metals, and electrolytes. Control solutions contained no calcium or phosphate. Solutions were analyzed for particle size and particle count. Means of Z-average particle size and particle counts of controls were determined. Study solutions were compared to controls and United States Pharmacopeia (USP) Chapter 788 guidelines. The maximum amount of Phos that was compatible in solutions that contained at least 10 mmol/L of Ca in 2.5% amino acids (AA) was determined. Compatibility of these solutions was verified by performing analyses of 5 repeats of these solutions. Microscopic analyses of the repeats were also performed. Results Amounts of CaCl2 and NaPhos that were compatible in solutions containing 1.5%, 2%, 2.5%, and 3% AA were determined. The maximum amount of NaPhos that could be added to Trophamine solutions of > = 2.5% AA containing at least 10 mmol/L of CaCl2 was 7.5 mmol/L. Adding 50 mg/dL of cysteine increased the amount of NaPhos that could be added to solutions containing 10 mmol/L of CaCl2 to 10 mmol/L. Conclusion Calcium chloride can be added to neonatal PN solutions containing NaPhos in concentrations that can potentially provide an intravenous intake of adequate amounts of calcium and phosphorus.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2: calcium chloride; NaPhos: sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate Without Cysteine.
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Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:CaCl2, calcium chloride; NaPhos, sodium phosphate.aOne mmol of calcium equals 40 mg or 2 mEq.Maximum Concentrations (mmol/L)a of Elemental Calcium (as CaCl2) Allowable in Trophamine Solutions Containing Sodium Phosphate With Added Cysteine (50 mg/dL).
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Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:Ca, calcium; CaCl2, calcium chloride; MFI, micro-flow imaging; Micro, microscopic; Phos, phosphate; SD, standard deviation; Z-Ave, Zetasizer Z-average particle diameter.aN = 5 for all groups.bOne mmol of elemental calcium equals 40 mg or 2 mEq.cParticle count per mL.Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate Without Added Cysteine (Mean±SD).
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Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate With Added Cysteine of 50 mg/dL (Mean±SD).
2015Co-Authors: Robert K Huston, Sumeia M Mohamed, Mark J. Christensen, Sultan M. Alshahrani, Sara M. Clark, Jeffrey A. NasonAbstract:Ca, calcium; CaCl2, calcium chloride; MFI, micro-flow imaging; Micro, microscopic; Phos, phosphate; SD, standard deviation; Z-Ave, Zetasizer Z-average particle diameter.aN = 5 for all groups.bOne mmol of elemental calcium equals 40 mg or 2 mEq.cParticle count per mL.Compatibility Studies for 2.5% Trophamine Solutionsa Containing CaCl2 and Sodium Phosphate With Added Cysteine of 50 mg/dL (Mean±SD).
