Parental nutrition of adults and children over 2 years of age, in whom oral or enteral nutrition is impossible, insufficient or contraindicated.
Composition:
A three-chamber container containing, in separate chambers, a solution of Glucose, amino acids with electrolytes and a fat emulsion. 1000 ml of the mixture obtained after combining the contents of the chambers contain: 35.4 g soya oil, 67.5 g glucose, 3.3 g L-alanine, 2.3 g L-arginine, 0.7 g L-aspartic acid, 1, 2 g L-glutamic acid, 1.7 g Glycine, 1.4 g L-histidine, 1.2 g L-isoleucine, 1.7 g L-leucine, 1.9 g L-lysine, 1.2 g L -methionine, 1.7 g L-phenylalanine, 1.4 g L-proline, 0.94 g L-serine, 1.2 g L-threonine, 0.4 g L-tryptophan, 0.05 g L-tyrosine , 1.5 g L-valine and 0.15 g Calcium chloride 1.04 g sodium glycerophosphate, 0.33 g Magnesium sulfate, 1.25 g potassium chloride, 1 g sodium acetate. Energy value: about 710 kcal. Nitrogen content: 3.7 g. Osmolality: about 830 mOsm / kg H2O, osmolality: about 750 mOsm / l, pH about 5.6.
Action:
Emulsion intended for parenteral nutrition, containing a set of amino acids, electrolytes, Glucose and soybean oil.
Contraindications:
Hypersensitivity to egg protein, soy, peanut or other ingredients of the preparation. Severe hyperlipidaemia, severe hepatic failure, severe blood clotting disorders, congenital defects in amino acid metabolism, severe renal failure in the absence of hemofiltration or dialysis, shock, hyperglycaemia requiring insulin at a dose above 6 U / h, pathologically increased blood levels of any of the electrolytes found in the preparation, acute pulmonary edema, conduction, decompensated heart failure and hypotonic dehydration, hemophagocytic syndrome, unstable general condition of the patient (severe post-traumatic condition, decompensated diabetes, myocardial infarction, metabolic acidosis, severe sepsis, hyperosmotic coma). Children under 2 years of age. Do not administer the product simultaneously with blood or blood products in one infusion set (danger of pseudoagglutination).
Precautions:
Particularly cautiously administered to patients with fat management disorders in renal failure, decompensated diabetes, pancreatitis, impaired hepatic function, hypothyroidism (with hypertriglyceridaemia) or sepsis (triglyceride monitoring should be monitored). Particularly cautiously use in patients with mild metabolic acidosis, with increased plasma osmolarity or those requiring water balance compensation. Use with caution in patients with a tendency to retain electrolytes or in undernourished patients.
Pregnancy and lactation:
The safety of the preparation during pregnancy and lactation has not been established.
Side effects:
The following may occur: increase in body temperature, less tremor, chills, nausea and vomiting. Very rare: hypersensitivity reactions (anaphylactic reaction - immediate discontinuation of the infusion, rash, urticaria), rapid breathing, hypertension and hypotension, haemolysis, reticulocytosis, abdominal pain, headache, fatigue and priapism. A transient increase in liver enzymes has been reported. After administration of the product into the peripheral veins, thrombophlebitis may occur. In malnourished patients, the preparation may cause congestive heart failure and pulmonary edema. In patients with reduced fat-elimination capacity, severe liver and kidney problems and infections, "fat overload syndrome" may occur (hyperlipidemia, fever, enlarged liver and spleen, anemia, leukopenia, thrombocytopenia, blood coagulation disorders, coma).
Dosage:
Intravenously (into a peripheral or central vein) by drip infusion; dosage and infusion rate individually, depending on the ability to eliminate fats and metabolize glucose.Adults and children over 10 years of age: usually 0.1-0.15 g nitrogen / kg / day (27-40 ml of the preparation / kg / day); patients with moderate or severe metabolic stress: 0.15-0.3 g nitrogen / kg / day. Maximum infusion rate: 3.7 ml / kg / h, duration of infusion: 12-24 h. Children over 2 years of age: initially 14-28 ml / kg / day, then the dose should be increased by 10-15 ml / kg / day, up to the maximum dose - 40 ml / kg / body / day.
(C)
