[Calcium and phosphates compatibilities in parenteral nutrition admixtures]

Abstract

Parenteral nutrition is actually a known method of administration of nutriments but not without risk. During the compounding of parenteral nutrition (PN) mixtures, the most pharmaceutical problem is the addition of calcium and phosphates. Since this two minerals can form insoluble precipitate that will lead to catheter occlusions and/or pulmonary emboli. Several reports has been related about suspect deaths following a PN infusion contaminated by precipitates or particles, this situation led the Food and Drug Administration (FDA) to recommend the use of filters. The precipitation of calcium phosphate is not easily predictable when the concentrations of these two salts are high and this situation constitute one of the major danger that can destabilise the parenteral nutrition admixture. Although such events still appear to be rare, it should be possible to eliminate them with improved pharmaceutical practice.