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3PC-027 Use of automated compounding devices in paediatric parenteral nutrition: a good way to ensure safety
  1. E Guerrero Hurtado,
  2. AM Padilla López,
  3. A Vázquez Polo,
  4. P Polo Montanero,
  5. A Cruz Sánchez,
  6. E López Briz
  1. Hospital Universitario y Politécnico La Fe, Pharmacy, Valencia, Spain


Background and Importance Parenteral nutrition (PN), particularly in paediatric patients, is a complex and high-risk therapy due to small volumes and high susceptibility. Expert recommendations advocate the use of automated compounding devices (ACD) to enhance the safety and quality of paediatric parenteral nutrition (PPN).

Aim and Objectives To evaluate the implementation of an ACD, taking into account criteria related to complexity of the task, safety and workload, as well as the quality and safety of the PN.

Material and Methods Observational and retrospective study from January to June 2023 in a tertiary care hospital. The number, volume, weight and composition of the PPNs prepared during this period were evaluated. Quality and safety of the admixtures were evaluated through the alerts observed (weight deviation). The weight limit deviation accepted was set in +/-5% for PPN over 100 mL and +/-3% for PPN with a volume of 100 mL or less. The impact on the workload will be assessed based on production times.

Results During the study period, 2.483 units were prepared, consisting of individualised PPN for 190 patients and stock preparations.

The breakdown below offers detailed information about the PNs, patient characteristics and the time needed for the whole compounding process, in paediatrics with the ACD and adults, where a vacuum filling machine is used:

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An average of 27 nutrients were used to prepare the PPNs (minimum: 4, maximum: 33). In 2.133 units (86%) heparin was manually added after the completion of the compounding.

The range of weight deviation was [4,14%,-2,43%]. The median was 0,85%. No deviation >5% has been recorded in PPNs with a volume >100 mL. In PPNs with a volume <100 mL all deviations observed were <3%.

Conclusion and Relevance The use of an ACD has ensured process quality and safety, as no significant weight deviations were observed despite the diversity of volumes. Furthermore, it reduces the operator’s handling, simplifying the task, minimising the risk of microbiological contamination and the likelihood of errors, without increasing the processing times compared to less precise methods.

Given the complexity of preparations and the achieved results, automating PPN preparation processes proves to be an efficient, safe, and precise method for compounding admixtures

Conflict of Interest No conflict of interest.

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