A Study of the Flow Reduction Mechanism in Several Brands of TPN Administration Using a TPN Solution Mixed with Total Vitamins for Injection

It is well known that controlling the infusion rate is necessary, when administering total parenteral nutrition (TPN). We recently observed a significant reduction in the flow rate caused by several brands of TPN administration using Hicaliq® RF (HRF) mixed with total vitamin injection. In the present study, we investigated the flow rate reduction mechanism between several bands of TPN. The flow rate decreased in cases of TPN solution mixed with some vitamins for injection which contained lipophilic vitamins. These vitamins contained polyoxyethylene (20) sorbitan monooleate as a solubilizer of lipophilic vitamin. A reduction of the flow rate was observed in the TPN administration sets using an in-line filter which has a symmetric membrane structure, whereas the filter of the asymmetric membrane structure in the TPN administration set did not show a flow rate reduction. The lowest flow rate was observed in HRF, of all the TPN solutions used in the present study because 50% glucose in HRF showed a higher viscosity. There is possibility that an unstable flow rate was obtained in the case of a positioning failure of the TPN bag caused by the patient, when administering HRF mixed with polyoxyethylene (20) sorbitan monooleate containing total vitamins for injection.