Standard solution

Amino acid sln (Aminosyn) 7-10% 500 mL

Dextrose 40-70% 500 mL

Sodium 35 mEq

Potassium 36 mEq

Chloride 35 mEq

Calcium 4.5 mEq

Phosphate 9 mmol

Magnesium 8.0 mEq

Acetate 82-104 mEq

Multi-trace element formula 1 mL/d

(Zn, copper, manganese, chromium)

Regular insulin (if indicated) 10-60 U/L

Multivitamin(12)(2 amp) 10 mL/d

Vitamin K (in solution, SQ, IM) 10 mg/week

Vitamin B12 1000 mcg/week

Selenium (after 20 days of continuous TPN) 80 mcg/d

Intralipid 20%, 500 mL/d IVPB; infuse in parallel with standard solution at 1 mL/min for 15 min; if no adverse reactions, increase to 100 mL/hr once daily or 20 mg/hr continuously. Obtain serum triglyceride 6h after end of infusion (maintain <250 mg/dL). Cyclic Total Parenteral Nutrition: -12h night schedule; taper continuous infusion in morning by reducing rate to half of original rate for 1 hour. Further reduce rate by half for an additional hour, then discontinue. Finger stick glucose q4-6h; restart TPN in afternoon. Taper at beginning and end of cycle. Final rate of 185 mL/hr for 9-10 h and 2 hours of taper at each end for total of 2000 mL. Peripheral Parenteral Supplementation: -3% amino acid sln (ProCalamine) up to 3 L/d at 125 cc/h OR -Combine 500 mL amino acid solution 7% or 10% (Aminosyn) and 500 mL 20% dextrose and electrolyte additive. Infuse at up to 100 cc/hr in parallel with:

-Intralipid 10% or 20% at 1 mL/min for 15 min (test dose); if no adverse reactions, infuse 500 mL/d at 21 mL/h over 24h, or up to 100 mL/h over 5 hours daily.

-Draw triglyceride level 6h after end of Intralipid infusion.

Was this article helpful?

0 0
Diabetes Sustenance

Diabetes Sustenance

Get All The Support And Guidance You Need To Be A Success At Dealing With Diabetes The Healthy Way. This Book Is One Of The Most Valuable Resources In The World When It Comes To Learning How Nutritional Supplements Can Control Sugar Levels.

Get My Free Ebook

Post a comment