@article{
author = "Mirković, Dušica and Ibrić, Svetlana and Antunović, Mirjana",
year = "2013",
abstract = "Background/Aim. Parenteral nutrition as a specific aspect of providing nutritients still remains a permanent topic of both theoretical and experimental research. Total parenteral nutrition (TPN) admixtures have complex contents making difficult to maintain their stability. The most critical parameter is the diameter of a lipid droplet, i.e. droplet size distribution. It is recommended that droplet size should not be more than 5 m and that the presence of greater droplets should not exceed the value of 0.05%. Lipid droplets size is affected particularly by electrolyte addition, especially polyvalent cations. There is a danger of the added electrolytes interaction with lipid droplets which leads to their aggregation and negative effects upon the admixtures stability. The aim of this study was to assess the effect of added electrolyte and lipid phase quantity on the admixture stability. Methods. Electrolytes were added to the studied admixture of a defined basic formulation contents in accordance with recommendations from the literature. Droplets size measurements were performed using the method of laser diffraction with a laser particles analyzer. Effects of independent variables were calculated and evaluated using commercial software. Na+, K+, Ca2+ and Mg2+ concentrations, as well as the quantity of fat phase were chosen as studied factors, i.e. independent variables. The system response, or dependent variable was the median of droplets size. Each of the factors was varied at two levels, higher (+1) and lower (-1), according to the 25-2 fractional factorial design. Results. The study suggested the presence of relative uniformity of the results of all the measurements regardless of the quantity of added electrolytes and lipid phase. It was shown that undoubtedly there is the influence of 2-valent cations (calcium and magnesium) upon lipid droplets size, which is in a direct correlation with theoretical assumption. Conclusion. Within a 72-hour testing period there was no significant increase in droplet size, i.e. the studied admixtures remained stable considering droplet size median as the criterion of stability., Uvod/Cilj. Parenteralna ishrana, kao specifičan vid nadoknade hranljivih materija, i dalje predstavlja stalnu temu teorijskog i eksperimentalnog izučavanja. Složeni sastav smeše za totalnu parenteralnu ishranu (TPI) otežava održanje njihove stabilnosti. Najkritičniji parameter je dijametar lipidnih kapi, odnosno raspodela veličina kapi. Postoji preporuka da veličina kapi ne bi trebalo da prelazi 5 μm i da zastupljenost većih kapi ne prelazi vrednost od 0,05%. Na veličinu lipidnih kapi poseban uticaj ima dodavanje elektrolita, naročito viševalentnih katjona. Postoji opasnost da dodati elektroliti interreaguju sa lipidnim kapima, što dovodi do njihovog spajanja i ima negativan uticaj na stabilnost smeša. Cilj ovog rada bio je da se istraži kako dodati elektroliti i količina lipidne faze utiču na stabilnost ovih smeša. Metode. Ispitivanoj smeši sa definisanim sastavom osnovne formulacije izrađenoj u bolničkoj apoteci, dodavani su elektroliti na osnovu preporuka iz literature. Merenje veličine kapi vršeno je metodom laserske difrakcije pomoću laserskog analizatora čestica. Uticaj nezavisno promenljivih je procenjen i izračunat primenom komercijalnog softvera. Kao nezavisno promenljive, u svojstvu ispitivanih faktora izabrani su koncentracije Na+, K+, Ca2+ i Mg2+, kao i količina masne faze. Odgovor sistema, ili zavisno promenljiva veličina, bila je medijana veličine kapi. Svaki od faktora variran je na dva nivoa, gornji (+1) i donji (-1), odnosno primenjen je 25-2 frakcioni faktorijalni dizajn. Rezultati. Istraživanje je pokazalo da nezavisno od količine dodatih elektrolita i količine lipidne faze postoji relativna ujednačenost rezultata za sva merenja. Analiza pojedinačnih faktora ukazuje na nesumnjiv uticaj dvovalentnih katjona (kalcijuma i magnezijuma) na veličinu lipidnih kapi, što je u direktnoj korelaciji sa teoretskim postavkama. Zaključak: Tokom ispitivanog 72-časovnog perioda nije bilo značajnog povećanja veličine kapi, odnosno ispitivana smeša ostala je stabilna sa stanovišta medijane veličine kapi kao kriterijuma stabilnosti.",
publisher = "Vojnomedicinska akademija - Institut za naučne informacije, Beograd",
journal = "Vojnosanitetski pregled",
title = "Quality assessment of total parenteral nutrition admixtures by the use of fractional factorial design, Analiza kvaliteta smeša za totalnu parenteralnu ishranu primenom delimičnog faktorijalnog dizajna",
volume = "70",
number = "4",
pages = "374-379",
doi = "10.2298/VSP1304374M"
}