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Infection Control in Parenteral Nutrition Preparation and Compounding
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Ji Hyeong Choe, Jin Hee Baek, Yun Hee Jo, Yoon Sook Cho
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J Clin Nutr 2018;10(2):31-37. Published online December 31, 2018
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DOI: https://doi.org/10.15747/jcn.2018.10.2.31
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Correction in: Ann Clin Nutr Metab 2019;11(1):29
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Abstract
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Recently, in Korea, the importance of preparation and use of injectable drugs has been emphasized due to successive fatal accidents caused by injection infections. Parenteral nutrition (PN) has also been identified as a cause of infection. Cases of infection due to PN have been reported not only in Korea, but also abroad, and contamination occurs mainly during the preparation of PN. Because sterile preparation and compounding of injections are very important for infection control and patient safety, this article reviews the major guidelines outlined thus far. The Korea Ministry of Food and Drug Safety in 2006 published guidelines and the KSHP (Korean Society of Health-System Pharmacists) recently issued guidelines for the aseptic preparation of injections. In addition, as US guidelines, the ASHP (American Society of Health-System Pharmacists) guidelines and United States Pharmacopeia (USP) <797> are also reviewed. The recent guidelines published by the KSHP have significance in that they were adopted in accordance with the domestic reality, even though they conform to foreign guidelines, and are expected to be guidelines for hospital pharmacists performing aseptic preparation work. In addition, the Korea Ministry of Health and Welfare is considering appropriate guidelines for the safe management of medications, training staff for infection prevention and strengthening staff capacity. Furthermore, the gradual expansion of aseptic compounding facilities and human resources, as well as the provision of adequate medical costs are also considered. Based on the establishment and standardization of injectable drugs compounding guidelines for Korean hospitals, it is believed that if human resources and facilities are supported and medical charges are improved, it will be possible to expect the safer preparation and use of injections.
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Effect of Fish Oil-based Intravenous Fat Emulsion with Parenteral Nutrition in Patients Undergoing Allogeneic Hematopoietic Stem Cell Transplantation
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Ji Hyeong Choe, Young Joo Lee, Hye Jung Bae, Sun Hoi Jung, Hyeon Joo Hahn, Yungil Koh
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J Clin Nutr 2016;8(1):29-35. Published online April 30, 2016
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DOI: https://doi.org/10.15747/jcn.2016.8.1.29
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Abstract
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Purpose:Omega-3 fatty acid is known for immunonutrition in that it has anti-inflammatory properties and improves the patients’ immune function. The objective of this study was to determine the effects of a fish oil-based lipid emulsion for adult patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). Methods:This was a retrospective study of 90 adult allogeneic HSCT patients from July 2011 to June 2015. The patients were divided into two groups according to the lipid type provided; fish oil group (FO group, n=55) and non-fish oil group (NFO group, n=35). The demographics, parenteral nutrition and lipid emulsion duration, length of hospital stay (LOS), weight change, 30 day mortality, survival period, incidence of acute graft-versus-host disease (aGVHD), neutropenic fever, sepsis, and re-hospitalization were collected from the electronic medical records. Results:The patients’ characteristics including age, sex, body mass index, and underlying disease were similar in the two groups. The incidence of aGVHD and infectious complications, mortality, LOS, re-hospitalization were also similar. The FO group showed weight gains, whereas the NFO group showed weight loss (FO vs. NFO=0.34% vs. ?1.08%, P=0.245). Conclusion:The clinical outcomes were similar in the two groups but there was a tendency for gain weight in the FO group. A large, well designed study, and a dosing study will also be needed to determine the optimal dose range for HSCT patients.
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