Abstract
1. Current status of our intravenous hyperalimentation (IVH)
As discussed on our first report, formulation and preparation of IVH nutrient solution were carried out in our hospital pharmacy for the first 2 years from 1973 According to the clinical development of IVH for the past 7 years, the nutrient solution has been only prepared in individual units immediately prior to its administration. The preparation has been made with several combinations of fluid and drugs which are currently available in sterilized bottles and ampules. The basic nutrient solution consists of 10% glucose, 10% amino acid, electrolytes, minerals and vitamins. Fifty% glucose is added when caloric increase is undertaken.
2. Management on stability and safety of IVH nutrient Discussion has been made on serial decomposition of FAD (Vitamin B2) and Vitamin K under light exposure.
One packed IVH system which supplies a whole mixture of the nutrient for 24 hours may have some pharmaceutical problems on stability and efficiency of the nutrient solution. Based on our experimental results, we have never used one packed IVH system.
In order to keep photo-stability of IVH solution, a light-proof cover was devised in our pharmacy. This covers a fluid bottle and minimizes decomposition of photosensitive vitamins during infusion.
3. Transrectal administration of fat soluble vitamins
Fat soluble vitamins such as Vitamins A, D and E are not given intravenously. Frequent multiple injection with pain is the sole problem for the patients who are unable to have oral intake during IVH. For this reason, transrectal administration has been undertaken experimentally on rabbits with suppositories containing these vitamins.
Although we have not yet had an expected result on rectal absorption, further investigation is in progress.
