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Doubling Calcium and Phosphate Concentrations in Neonatal Parenteral Nutrition Solutions Using Monobasic Potassium Phosphate

Joyce C. Wong, BSc Pharm, Albert R. McDougal, BSc Pharm, Marianne Tofan, Dipl Pharm, Jasvinder Aulakh, BSc, Marjolan Pineault, PhD and Philippe Chessex, MD, FRCPC

Department of Pharmacy (J.C.W., A.R.M., M.T.)
Division of Neonatology (J.A., P.C.)
Children’s and Women’s Health Centre of BC, Vancouver, British Columbia, Department of Pharmacy, Hospital Ste-Justine, Montreal, Quebec (M.P.), CANADA


Figure 1
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  		Fig. 1. Maximum concentration of calcium and phosphate attainable without macroscopic or microscopic evidence of precipitation in various amino acid solutions using monobasic or dibasic regimen. Trophamine and Aminosyn-PF are prepared with 40 mg HCL cysteine/g amino acid.

 

Figure 2
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  		Fig. 2. Evidence of precipitation using the dibasic regimen in various amino acid solutions at increasing calcium and phosphate concentrations in a 1:1 molar ratio. Solutions were observed at three phases: immediately (t = 0 h), 24h after preparation (ppt) at room temperature (t = 24 h), and 3 hours at 37°C following 24h at room temperature (t = 27 h). Within each phase, macroscopic analysis was performed with subsequent microscopic analysis. Trophamine and Aminosyn-PF are prepared with added 40 mg HCL cysteine/g amino acid.

 

Figure 3
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  		Fig. 3. Evidence of precipitation using the monobasic regimen in various amino acid solutions at increasing calcium and phosphate concentrations in a 1:1 molar ratio. Solutions were observed at three phases: immediately (t = 0 h), 24h after preparation (ppt) at room temperature (t = 24 h), and 3 hours at 37°C following 24h at room temperature (t = 27 h). Within each phase, macroscopic analysis was performed with subsequent microscopic analysis. Trophamine and Aminosyn-PF are prepared with added 40 mg HCL cysteine/g amino acid.

 

Figure 4
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  		Fig. 4. Titration curves of five 3% amino acid solutions using standardized 0.1 M sodium hydroxide. Variance is not depicted when it is smaller than the size of the symbol. Trophamine and Aminosyn-PF are prepared with added 40 mg HCL cysteine/g amino acid.

 




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