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MON-PP012: Evaluation of Chemical Stability of Vitamins and Physicochemical Stability of Parenteral Nutrition in UV Protection Eva Bags
Poster tour 7: Parenteral Nutrition Hospital stay (days) TLS ALT
15.6±1.5 16.8±2.6
Catheter removal 0 3*
S131
BMI (kg/m2 )
Albumin (g/L)
Duration of HPN (months)
CRP (mg/L)
22.5±3.1 23.6±1.8
38.1±4.3 33.9±6.9
43.5±35.2 38.2±29.7
22.1±9.0 19.3±7.6
*P < 0.05 TLS versus ALT regimen, mean±SE.
Conclusion: An antibiotic-lock therapy regimen of the treatment for the catheter-associated bloodstream infection (CBSI) lengthened the hospital stay and was associated with therapeutic failures and the need for catheter removal. Thus the taurolidine citrate lock solution regimen might be favorable in the therapy of CBSI in patients on home parenteral nutrition. This work was supported by IGA MH CR NT/12287 5, PRVOUK P37/12, Long-Term Organization Development Plan 1011 (FMHS) and Specific Research Project . . . FVZ201510Parenteral nutrition (FMHS). Disclosure of Interest: None declared
MON-PP011 Outstanding abstract FIBROBLAST GROWTH FACTOR 19 IN PATIENTS WITH SHORT BOWEL SYNDROME ON LONG-TERM HOME PARENTERAL NUTRITION M. Montagnani1 , M. Guidetti2 , F. Agostini2 , P. Simoni1 , S. Demurtas1 , C. Pazzeschi2 , R. Aldini1 , L. Pironi2 . 1 Gastroenterology Unit, St Orsola-Malpighi Hospital, University of Bologna, Italy; 2 Chronic Intestinal Failure Center, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy Rationale: Fibroblast Growth Factor 19 (FGF19) is a peptide produced in the distal ileum upon bile acid absorption. It down-regulates hepatic bile acid synthesis. In short bowel syndrome (SBS) there is an interruption of the entero-hepatic circulation of bile acids, which may cause an overstimulation of BAs synthesis. We investigated fasting serum FGF19 in a group of adult patients with SBS on long-term home parenteral nutrition (HPN). Methods: A cross sectional study was performed in 18 patients with SBS without distal ileum (No-DIL), in 6 patients with SBS with a tract of distal ileum remaining (DIL) and in 8 healthy subjects (HS). Inclusion criteria: HPN duration 4 months, PN infusions/week 2 weeks. Exclusion criteria: malignant disease. Serum FGF19 concentration was measured after an overnight oral fasting, by a solid-phase ELISA method. Statistics: Median and 95% Confidence Interval (95% CI); non parametric tests. Results: Serum FGF19 was lower than the range observed in HS (95% CI: 46.5 288 pg/mL) in all the No-DIL patients (undetectable in 6) and one half of the DIL patients. FGF19 was higher in DIL than in No-DIL patients (43.3 vs 4.1 pg/mL; p = 0.004). In No-DIL patients the HPN admixtures was lipidbased in 2 of the 6 patients with undetectable FGF19 and in 10 of 12 patients with detectable FGF19 value (p = 0.107). In NoDIL patients, FGF19 was positively associated with the weekly amount of lipids infused with HPN (r = 0.772; p = 0.001). This correlation was not observed in DIL patients. Conclusion: The detection of low serum concentrations of FGF19 in No-DIL SBS patients suggests a non-ileal FGF19 production. The positive association between FGF19 and the amount of lipid infused with HPN in no-DIL SBS patients would suggests that intravenous lipids may induce an FGF19
production from extra-intestinal tissues. The reason and the role of this production have to be investigated. Disclosure of Interest: None declared
MON-PP012 Outstanding abstract EVALUATION OF CHEMICAL STABILITY OF VITAMINS AND PHYSICOCHEMICAL STABILITY OF PARENTERAL NUTRITION IN UV PROTECTION EVA BAGS D.A. Watrobska-Swietlikowska1 , M. Stawny2 , A. Gostynska2 . 1 Department of Pharmaceutical Technology, Medical University of Gdansk, Gdansk, 2 Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, Pozna´ n, Poland Rationale: Parenteral nutrition is probably the most complex medication used in modern medicine. It shows almost 50 different components that are mixed together and coexist together in one bag. Such complicity brings a serious risk of developing many interactions, both between components and also between components and the packaging material. The aim of the study was evaluation of chemical stability of vitamins and physicochemical stability of parenteral nutrition for neonatal use stored up to 8 days in UV protection bags. Methods: Parenteral admixtures were prepared at Hospital Pharmacy of University Children’s Hospital of Cracow. Admixtures were subjected to physicochemical stability analysis consisting of visual inspection, microscopic observation, pH measurement and determination of the size distribution of oily droplets using LD and PCS method. In order to determine ascorbic acid, thiamine and riboflavine the HPLC method was used. Results: On microscopic observation, the majority of the admixtures were characterized by the size of oily droplets not larger than 1 2 mm, considered to be safe for patients. The median size of oily droplets in the final admixtures was determined to be 300 330 nm; 90% of oily droplets were under 590 680 nm. The size of oily droplets did not change following 24-hour storage at room temperature. Both the pH values as well as zeta potential of TPN admixtures did not change during storage. The obtained results from chemical analysis have shown that were no significant differences in the contents of ascorbic acid, thiamine and riboflavine in studied parenteral nutrition mixtures. Conclusion: Admixtures can be stored in EVA UV protection bags up to 8 days at 4ºC. The observed contents of studied vitamins were in the same level independently of the composition of the parenteral nutrition mixtures and the type of the UV protection EVA bag (one or two chamber). Disclosure of Interest: None declared
15.6±1.5 16.8±2.6
Catheter removal 0 3*
S131
BMI (kg/m2 )
Albumin (g/L)
Duration of HPN (months)
CRP (mg/L)
22.5±3.1 23.6±1.8
38.1±4.3 33.9±6.9
43.5±35.2 38.2±29.7
22.1±9.0 19.3±7.6
*P < 0.05 TLS versus ALT regimen, mean±SE.
Conclusion: An antibiotic-lock therapy regimen of the treatment for the catheter-associated bloodstream infection (CBSI) lengthened the hospital stay and was associated with therapeutic failures and the need for catheter removal. Thus the taurolidine citrate lock solution regimen might be favorable in the therapy of CBSI in patients on home parenteral nutrition. This work was supported by IGA MH CR NT/12287 5, PRVOUK P37/12, Long-Term Organization Development Plan 1011 (FMHS) and Specific Research Project . . . FVZ201510Parenteral nutrition (FMHS). Disclosure of Interest: None declared
MON-PP011 Outstanding abstract FIBROBLAST GROWTH FACTOR 19 IN PATIENTS WITH SHORT BOWEL SYNDROME ON LONG-TERM HOME PARENTERAL NUTRITION M. Montagnani1 , M. Guidetti2 , F. Agostini2 , P. Simoni1 , S. Demurtas1 , C. Pazzeschi2 , R. Aldini1 , L. Pironi2 . 1 Gastroenterology Unit, St Orsola-Malpighi Hospital, University of Bologna, Italy; 2 Chronic Intestinal Failure Center, St Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy Rationale: Fibroblast Growth Factor 19 (FGF19) is a peptide produced in the distal ileum upon bile acid absorption. It down-regulates hepatic bile acid synthesis. In short bowel syndrome (SBS) there is an interruption of the entero-hepatic circulation of bile acids, which may cause an overstimulation of BAs synthesis. We investigated fasting serum FGF19 in a group of adult patients with SBS on long-term home parenteral nutrition (HPN). Methods: A cross sectional study was performed in 18 patients with SBS without distal ileum (No-DIL), in 6 patients with SBS with a tract of distal ileum remaining (DIL) and in 8 healthy subjects (HS). Inclusion criteria: HPN duration 4 months, PN infusions/week 2 weeks. Exclusion criteria: malignant disease. Serum FGF19 concentration was measured after an overnight oral fasting, by a solid-phase ELISA method. Statistics: Median and 95% Confidence Interval (95% CI); non parametric tests. Results: Serum FGF19 was lower than the range observed in HS (95% CI: 46.5 288 pg/mL) in all the No-DIL patients (undetectable in 6) and one half of the DIL patients. FGF19 was higher in DIL than in No-DIL patients (43.3 vs 4.1 pg/mL; p = 0.004). In No-DIL patients the HPN admixtures was lipidbased in 2 of the 6 patients with undetectable FGF19 and in 10 of 12 patients with detectable FGF19 value (p = 0.107). In NoDIL patients, FGF19 was positively associated with the weekly amount of lipids infused with HPN (r = 0.772; p = 0.001). This correlation was not observed in DIL patients. Conclusion: The detection of low serum concentrations of FGF19 in No-DIL SBS patients suggests a non-ileal FGF19 production. The positive association between FGF19 and the amount of lipid infused with HPN in no-DIL SBS patients would suggests that intravenous lipids may induce an FGF19
production from extra-intestinal tissues. The reason and the role of this production have to be investigated. Disclosure of Interest: None declared
MON-PP012 Outstanding abstract EVALUATION OF CHEMICAL STABILITY OF VITAMINS AND PHYSICOCHEMICAL STABILITY OF PARENTERAL NUTRITION IN UV PROTECTION EVA BAGS D.A. Watrobska-Swietlikowska1 , M. Stawny2 , A. Gostynska2 . 1 Department of Pharmaceutical Technology, Medical University of Gdansk, Gdansk, 2 Department of Pharmaceutical Chemistry, Poznan University of Medical Sciences, Pozna´ n, Poland Rationale: Parenteral nutrition is probably the most complex medication used in modern medicine. It shows almost 50 different components that are mixed together and coexist together in one bag. Such complicity brings a serious risk of developing many interactions, both between components and also between components and the packaging material. The aim of the study was evaluation of chemical stability of vitamins and physicochemical stability of parenteral nutrition for neonatal use stored up to 8 days in UV protection bags. Methods: Parenteral admixtures were prepared at Hospital Pharmacy of University Children’s Hospital of Cracow. Admixtures were subjected to physicochemical stability analysis consisting of visual inspection, microscopic observation, pH measurement and determination of the size distribution of oily droplets using LD and PCS method. In order to determine ascorbic acid, thiamine and riboflavine the HPLC method was used. Results: On microscopic observation, the majority of the admixtures were characterized by the size of oily droplets not larger than 1 2 mm, considered to be safe for patients. The median size of oily droplets in the final admixtures was determined to be 300 330 nm; 90% of oily droplets were under 590 680 nm. The size of oily droplets did not change following 24-hour storage at room temperature. Both the pH values as well as zeta potential of TPN admixtures did not change during storage. The obtained results from chemical analysis have shown that were no significant differences in the contents of ascorbic acid, thiamine and riboflavine in studied parenteral nutrition mixtures. Conclusion: Admixtures can be stored in EVA UV protection bags up to 8 days at 4ºC. The observed contents of studied vitamins were in the same level independently of the composition of the parenteral nutrition mixtures and the type of the UV protection EVA bag (one or two chamber). Disclosure of Interest: None declared