SmofKabiven extra Nitrogen

Per 1,000 mL Alanine 9.2 g, arginine 7.9 g, glycine 7.2 g, histidine 2 g, isoleucine 3.3 g, leucine 4.8 g, lysine (as acetate) 4.3 g, methionine 2.8 g, phenylalanine 3.3 g, proline 7.3 g, serine 4.3 g, taurine 0.65 g, threonine 2.9 g, tryptophan 1.3 g, tyrosine 0.26 g, valine 4.1 g, CaCl₂ 0.28 g, Na glycerophosphate 2.3 g, Mg sulphate 0.61 g, KCl 2.3 g, Na acetate 1.6 g, Zn sulphate 0.0066 g, glucose 85 g, refined soya-bean oil 8.7 g, medium-chain triglycerides 8.7 g, refined olive oil 7.2 g, fish oil (rich in omega-3 acids) 4.3 g. Energy: 889 kCal

Parenteral nutrition for adults & childn ≥2 yr when oral or enteral nutrition is impossible, insufficient, or contraindicated.

IV Adult & adolescent 12-18 yr 13-31 mL/kg daily infused over 14-24 hr. Max infusion rate: 1.5 mL/kg/hr. Max daily dose: 31 mL/kg. Childn 2-11 yr Up to 31 mL/kg daily infused over 12-24 hr & regularly adjusted to the requirements of the paed patient. Max infusion rate: 1.8 mL/kg/hr. Do not use an infusion period >17 hr at max infusion rate, except in exceptional cases & w/ careful monitoring.

Hypersensitivity to fish, egg, soya or peanut protein, or to any of the active substances or excipients. Congenital errors of amino acid metabolism. Pathologically elevated serum levels of any of the included electrolytes. Acute shock. Uncontrolled hyperglycaemia. Hemophagocytotic syndrome. General contraindications to infusion therapy (acute pulmonary oedema, hyperhydration, & decompensated cardiac insufficiency). Unstable conditions (eg, severe post-traumatic conditions, uncompensated DM, acute MI, stroke, embolism, metabolic acidosis, severe sepsis, hypotonic dehydration, & hyperosmolar coma). Severe hyperlipidemia. Severe blood coagulation disorders. Severe liver insufficiency. Severe renal insufficiency w/o access to hemofiltration or dialysis. Neonates & infants <2 yr.

Immediately interrupt infusion in case of any sign or symptom of anaphylactic reaction. Monitor serum triglycerides, glucose, electrolytes, osmolarity, fluid balance, acid-base status, liver enzyme tests, blood cell count, & coagulation. Serum triglyceride conc should not exceed 4 mmol/L during infusion as overdose may lead to fat overload syndrome. Correct disturbances of electrolyte & fluid balance before starting infusion. Carefully control phosphate & K intake to prevent hyperphosphatemia & hyperkalaemia in patients w/ renal insufficiency. Lipid content may interfere w/ lab measurements (eg, bilirubin, LDH, O₂ saturation, Hb) if blood is sampled before adequate clearance of lipids from the bloodstream. IV infusion of amino acids is accompanied by increased urinary excretion of trace elements, particularly Cu & Zn. Initiation of parenteral nutrition in malnourished patients can precipitate fluid shifts resulting in pulmonary oedema, CHF, & decreased serum conc of K, P, Mg, & water soluble vit. Do not give simultaneously w/ blood in the same infusion set due to risk of pseudoagglutination. Administration of exogenous insulin might be necessary in patients w/ hyperglycaemia. Strongly advisable not to add other soln if compatibility is not proven. Contains soya-bean oil, fish oil, & egg phospholipids. Administer w/ caution in conditions of impaired lipid metabolism, which may occur in patients w/ renal failure, DM, pancreatitis, impaired liver function, hypothyroidism, & sepsis; in lactic acidosis, insufficient cellular O₂ supply, & increased serum osmolarity; to patients w/ predisposition to electrolyte retention. Administer to pregnant & breast-feeding women only after careful consideration.

Slight increase in body temp.

Increased plasma lipolysis & transient decrease in triglyceride clearance w/ heparin.

Parenteral Nutritional Products

V06DE - Amino acids/carbohydrates/minerals/vitamins, combinations ; Used as general nutrients.

P₁S₁S₃