PEDIATRICS Vol. 52 No. 6 December 1973, pp. 864-866
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Crystal Formation: A New Complication of Total Parenteral Nutrition

Herbert H. Pomerance M.D., F.A.A.P.1 and Richard E. Rader B.S., PHAR.1

1 Departments of Pediatrics and Pharmacy, Charleston Area Medical Center, Charleston, West Virginia 25304

Since 1971, the Newborn Intensive Care Unit (NICU) of the Charleston Area Medical Center has developed considerable experience with Total Parenteral Nutrition (TPN). A new technical complication of this procedure has been encountered and is reported herewith. It is not the purpose of this communication to repeat the background of TPN,1 or to detail the case histories involved.

Initially, like others, we used a mixture containing a casein hydrolysate (5% Amigen and 5% Dextrose Injection*), additional glucose, and minerals including calcium gluconate. In May 1972 we changed our formula to include a fibrin hydrolysate (Aminosol 5% in D5Wdagger). At the same time, we added phosphate ion by changing from potassium chloride to potassium acid phosphate (Table I) .




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