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Effects of temperature and handling conditions on lipid emulsion stability in veterinary parenteral nutrition admixtures during simulated intravenous administration

Elizabeth J. Thomovsky DVM1, Robert C. Backus DVM, PhD2, F. A. Mann DVM, MS3, Cynthia K. Richmond BS, RVT, RPh4, and Colette C. Wagner-Mann MA, DVM, PhD5
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  • 1 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 2 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 3 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 4 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.
  • | 5 Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211.

Abstract

Objective—To determine whether lipid particle coalescence develops in veterinary parenteral nutrition (PN) admixture preparations that are kept at room temperature (23°C) for > 48 hours and whether that coalescence is prevented by admixture filtration, refrigeration, or agitation.

Sample Population—15 bags of veterinary PN solutions.

Procedures—Bags of a PN admixture preparation containing a lipid emulsion were suspended and maintained under different experimental conditions (3 bags/group) for 96 hours while admixtures were dispensed to simulate IV fluid administration (rate, 16 mL/h). Bags were kept static at 4°C (refrigeration); kept at 23°C (room temperature) and continuously agitated; kept at room temperature and agitated for 5 minutes every 4 hours; kept static at room temperature and filtered during delivery; or kept static at room temperature (control conditions). Admixture samples were collected at 0, 24, 48, 72, and 96 hours and examined via transmission electron microscopy to determine lipid particle diameters. At 96 hours, 2 samples were collected at a location distal to the filter from each bag in that group for bacterial culture.

Results—Distribution of lipid particle size in the control preparations and experimentally treated preparations did not differ significantly. A visible oil layer developed in continuously agitated preparations by 72 hours. Bacterial cultures of filtered samples yielded no growth.

Conclusions and Clinical Relevance—Data indicated that the veterinary PN admixtures kept static at 23°C are suitable for use for at least 48 hours. Manipulations of PN admixtures appear unnecessary to prolong lipid particle stability, and continuous agitation may hasten lipid breakdown.

Contributor Notes

Dr. Wagner-Mann's present address is Helias High School, 1305 Swifts Hwy, Jefferson City, MO 65109.

Supported by a grant from the Waltham Foundation.

Presented in abstract form at the 2007 International Veterinary Emergency and Critical Care Society Symposium, New Orleans, September 2007.

Address correspondence to Dr. Thomovsky.