Safety and Efficacy of Multi-chamber Bag Parenteral Nutrition

Abstract Background There is a significant degree of debate regarding the use of standardized parenteral solutions. Multi-chamber bag parenteral nutrition (MCB-PN) showed advantages over compounded PN in previous literature. Meanwhile, some literature has shown the limitations in use of MCB-PN. This study was conducted to evaluate the nutritional efficacy and safety of commercially available MCB-PN.Methods All adult hospitalized patients who have been on MCB-PN for at least seven consecutive days at King Faisal Specialist Hospital & Research Center in Riyadh from January 2015 until December 2019 were included. Laboratory parameters were evaluated before PN started, which was used as a baseline, and every seven days while on PN. Primary outcomes were the percentage of patients who achieved calculated target calories and protein and the percentage of patients who developed electrolyte abnormalities. The secondary outcome was a percentage of adverse drug reactions during the treatment period.Results Two hundred and thirty-one patients met the inclusion criteria. Among the included subjects, 101 (44%) achieved target calories; 29 (12.6%) were underweight; 40 (17.3%) were normal weight; 18 (7.8%) were overweight; and 14 (6.1%) were in obese subgroups, with p-value 0.145. Sixty-eight (29.6%) achieved the target protein dose; 26 (11.3%) were underweight; 33 (14.3%) were normal weight; five (2.2%) were overweight; and four (1.7%) were in obese subgroups, with p-value < 0.01. One hundred and ninety-one (83.4%) developed electrolyte imbalances; 39 (16.9%) were underweight; 87 (37.7%) were normal weight; 34 (14.7%) were overweight; and 34 (14.7%) were in obese subgroups, with p-value 0.085, during the treatment period. A small percentage of ADRs and metabolic abnormalities were reported during the treatment period.Conclusion Among patients receiving MCB-PN, only 44% achieved the caloric target, and 29.6% achieved the target protein dose with fewer percentages of ADRs.