How is total parenteral nutrition TPN produced

Total parenteral nutrition

Total parenteral nutrition (TPN)

Doctors understand parenteral nutrition to be a form of artificial nutrition that bypasses the gastrointestinal tract. It is used in hospitals when the patient cannot eat normal food due to illness. The goal of parenteral nutrition via an infusion solution is the optimal supply of the patient with all nutrients, calories, electrolytes, vitamins and trace elements. When designing the nutritional solution, individual patient data and the underlying disease must therefore be taken into account. For parenteral nutrition of adults, the pharmaceutical industry offers a number of standard infusion solutions with a certain mixing ratio and a fixed number of calories as so-called three-chamber bags. For many patients, however, individually tailored parenteral nutrition from the clinic pharmacy is the better solution, especially the small patients and especially the premature babies of the clinic for pediatric medicine.
Industrially manufactured three-chamber bags are not available for the parenteral supply of nutrients to children, as our doctors usually prefer individual care in order to adapt the nutrition of the small patients as optimally as possible. The composition of parenteral nutrition includes macronutrients such as carbohydrates, amino acids and fat, as well as micronutrients such as electrolytes, trace elements and vitamins.

The production of these patient-specific infusion solutions is carried out by specially trained employees of the pharmacy in a special production area, which is comparable to a modern operating theater in terms of its operational processes. By strictly adhering to the hygienic measures, the highest possible manufacturing quality of patient-specific infusion solutions for children and especially for our premature babies is achieved in these clean rooms.

Similar to the operating theater, these rooms can only be entered via staff sluices. In the lock, street clothing is exchanged for special protective clothing. Hand disinfection and putting on sterile gloves are part of the standard workflow. In order to keep the particle load in the clean rooms as low as possible, you have to z. B. take off his jewelry and must not wear make-up. In the clean room laboratory, everyone works under controlled pressure and climate conditions in a hygienically monitored environment. The preparation of the infusion solutions takes place in a so-called laminar air flow workbench equipped with laminar air flow, in which the air is again highly purified by special filters and is therefore practically free of particles.

Semi-automatic filling devices can be used for the mixing process, especially for smaller volumes in pediatrics. Filling is controlled by an automatic pump, which precisely measures individual volumes according to specifications and transfers them to the infusion bag. Electrolytes and vitamins are added manually after the mixing bag has been filled, and all connection lines and bacterial filters are already installed in the pharmacy under the same laminar air flow conditions. The children's ward thus receives a complete system that can be connected in a few simple steps.

The high standard of aseptic production and close cooperation with the doctors and nursing staff in the children's wards guarantee the highest level of drug safety.