Does anyone use PPN at their site?

[spacecowgirl]

Our dietitian wants to look into PPN for us vs TPN because we are a small facility where people are generally here for short stays and putting in a central line doesn't always seem to be the most prudent for our purposes. I really don't know a lot about PPN and I can't find much out there. Other sites in our organization don't use it either.

Any resources would be appreciated. I'm looking at the ASPEN manual as a start.

---

Members don't see this ad.

 

[StaviZFingerZ]

Don't reinvent the wheel. Just go with commercial product like Clinimix .. and if you contact Baxter, they'll provide you with the info.

 

[StaviZFingerZ]

And there's another product that comes in a liter glass bottle...which I can't remember the name of...for the life of me.. 😡

Don't break that bottle.. it's nasty.

 

[njac]

Procalamine!!

Old hospital switched from that to Clinimix.

New hospital compounds all in house. Too much work and room for error if you ask me.

 

[StaviZFingerZ]

Procalamine!!

👍 👍 👍 !!!!!!!!!!


Thanks resident. You're useful sometimes. I've been suffering with that brain teaser for the past 20 minutes!!!!!!!

 

[spacecowgirl]

We use Hospira products. I'm looking at the Aminosyn 3.5 in D5...

 

[StaviZFingerZ]

Get your calculator out and manually calculate the mOsm/L and impress everyone around you!

 

[spacecowgirl]

Get your calculator out and manually calculate the mOsm/L and impress everyone around you!

Are you talking to me or to the resident? Because I don't like calculating osmols and I don't like reinventing the wheel either.

 

[StaviZFingerZ]

Are you talking to me or to the resident? Because I don't like calculating osmols and I don't like reinventing the wheel either.

Boff y'all. Isn't it like grams of AA/L x 10 + grams of dex/L x something + all electrolyte meq/L x 2 or 3..

Geesh... I think it's been 15 years since I've done it for some test..

 

[bigpharmD]

Our dietitian wants to look into PPN for us vs TPN because we are a small facility where people are generally here for short stays and putting in a central line doesn't always seem to be the most prudent for our purposes. I really don't know a lot about PPN and I can't find much out there. Other sites in our organization don't use it either.

Any resources would be appreciated. I'm looking at the ASPEN manual as a start.

just give em some dextrose

 

[gotdrugs]

Clinimix isn't the best for renal (acute or chronic) patients - the phos content is kinda high (15 mmol/L)

The bigger question is why do PN at all? If it's mainly short stays, screw it, just give'em Dextrose as a PP said. If they think they will need PN after discharge for a longer term then they are going to need a central line (and thus TPN) anyways......

 

[spacecowgirl]

just give em some dextrose

The bigger question is why do PN at all? If it's mainly short stays, screw it, just give'em Dextrose as a PP said. If they think they will need PN after discharge for a longer term then they are going to need a central line (and thus TPN) anyways......

I don't disagree. I've brought it up several times that I think we initiate TPN too quickly in the first place. I haven't looked at the literature about healing times in pts with vs w/o PN as I think that is the rationale. You'd think the onus would be on the surgeons and dietitian to support their opinion, but it never seems to work that way...

 

[StaviZFingerZ]

Clinimix isn't the best for renal (acute or chronic) patients - the phos content is kinda high (15 mmol/L)

Isn't there a renal Clinimix? Don't make me look it up.

 

[gotdrugs]

Isn't there a renal Clinimix? Don't make me look it up.

I didn't know that. (Assuming you're correct)

I don't feel like looking it up because I stand by my other point (Don't bother)

 

[gotdrugs]

I don't disagree. I've brought it up several times that I think we initiate TPN too quickly in the first place. I haven't looked at the literature about healing times in pts with vs w/o PN as I think that is the rationale. You'd think the onus would be on the surgeons and dietitian to support their opinion, but it never seems to work that way...

They can probably drag out a bs article or two that was a poorly designed trial that would "support" that - but if you look at the literature as a whole for what you are talking about - nope, not to my knowledge.

Providing "nutrition support" is the biggest fuzzy area in medicine IMO, esp when it comes to patient outcomes. I'm not saying to never do it - just speaking for your situation. Again, I would be shocked if you found good evidence supporting what they are wanting to use it for.