Language: Spanish
References: 0
Page: S6-S7
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ABSTRACT

Rationale: Centralized provision of parenteral nutrition (PN) bags by a parenteral admixtures center can be a cost-effective solution for the nutritional support of the critically ill newborn. Ten years of continuing operation of the Pediatric Parenteral Admixtures Center (PPAC) of the Pharmacy Service of the Centro Habana Pediatric Hospital (Havana city, Cuba), in charge of providing NP orders to newborns assisted at pediatric hospitals of Havana city, have elapsed. Time is right for an appraisal of the performance of the center. Objectives: To describe the features of the newborns receiving PN orders compounded by the PPAC, the features of PN orders compounded and dispatched throughout these years, and to estimate the cost of compounding the PN order. Study design: Retrospective, analytical. Evolution of compounding practices of PN orders was assessed in three different moments: 2006; 2010; and 2015. Study serie: Newborns for whom PN orders were compounded at the PPAC between 2006 – 2015 (both inclusive): Females: 60.6%; Average hours of extrauterine life: 123 ± 211 hours [Minimum: 8 hours; Maximum: 480 hours]; Birth weight: 1,650 ± 1,165 Kg [Minimum: 450 Kg; Maximum: 4,400 Kg]. Material and method: Clinical charts from 723 newborns assisted during the observation window of the study were retrieved in order to collect data on nutrient and chemical composition of compounded PN orders. In addition, total and average costs of PN orders compounded at the PPAC were estimated. Results: Number of newborns receiving PN orders compounded by the center increased steadily over the years of operation: 2006: 7.9% of the size of the study serie; 2010: 26.7%; and 2015: 65.4%; respectively. Records of 2,668 PN orders compounded during the observation window were recovered. Number of PN orders dispatched by the center increased over time: 2006: 14.1% of recovered orders; 2010: 41.6%; and 2015: 44.3%; respectively. However, per capita number of PN orders diminished: 2006: 6.6 orders/newborn; 2010: 5.7; and 2015: 2.5; respectively. Number of PN orders started within the first 24 hours of life of the newborn increased steadily over the years: 2006: 0.0%; 2010: 5.2%; and 2015: 56.1%; respectively. Duration of PN schemes administered to newborns decreased with time: PN duration > 7 days: 2006: 25.0%; 2010:16.3%; and 2015: 18.4%; respectively. Nutritionally incomplete PN orders prevailed. Inclusion of parenteral lipids within the PN order compounded at the center diminished over time. Inclusion of oligoelements and trace minerals within the PN order was infrequent. Average cost of PN order was 17.57 ± 6.10 CUP. Average costs of expendable materials and pharmaceuticals represented 75.8% and 20.9%, respectively, of that of the PN order. Conclusions: A growing number of newborns has benefited from the performance of the PPAC. However, compounded PN orders were nutritionally incomplete and deprived of lipids, oligoelements and trace minerals. Administration of PN order is started lately, and prolonged over a short time. Expendable materials and pharmaceuticals represented major portions of the cost of compounding the PN order.