PeriOlimel® and Olimel® Standard Parenteral Nutrition Solutions (Adults) PeriOlimel® and Olimel® are standard parenteral nutrition solutions currently available for adults in Edmonton. They are “ready to mix”, 3-in-1 solution. The triple chamber bag contains amino acids, dextrose, 20% lipids, and standard predetermined amount of electrolytes. The advantages of using a standard parenteral solution is that it is latex free, cost effective, reduces contamination, and increases patient safety. There is a lower risk of contamination and mixing error. The limitations to a standard solution are that it does not meet the requirements for many complex patients (e.g. very obese, critically ill patients, those with high outputs drains/fistulas, electrolyte/fluid concerns, refeeding syndrome). The 2 Liter Olimel® (5.7% amino acid and 11% dextrose) solution is used for central total parenteral nutrition (TPN) and the 1 L PeriOlimel® (2.5% amino acid and 7.5% dextrose) solution is used for all peripheral parenteral nutrition (PPN). Pharmacy adds the multivitamins and trace elements to the first bag (Bag A) of the day, breaks seals and attaches patient’s label. The solution becomes a milky white color, which will be sent up to the units from Pharmacy. A 1.2 micron in-line filter infusion set is used (Smartsite Low Sorbing Infusion Set #10010453). Physicians will continue to order “TPN – Dietitian to assess.” Dietitians will determine if either standard PeriOlimel® or Olimel® solution, or compounded parenteral solution is appropriate for the patient. The PeriOlimel® and Olimel®are good for 48 hours refrigerated once the chambers are mixed. There is a 24 hour hang time after spiking. They are contraindicated in those with severe egg and soy allergy. PeriOlimel® is not recommended for use over 6 days. What is Olimel®? Lipid • • • • Amino Acids 3 in 1chamber parenteral nutrition (amino acids, dextrose, and 20% lipid) Multivitamin and trace element added separately by pharmacy Will not be able to adjust electrolyte content Peri-Olimel for peripheral PN and Olimel 5.7% for Central PN Dextrose 2 1) What stays the same with respect to ordering PN? *The dietitian will do an initial assessment, and decide if your patient is a candidate for Olimel®. If not, the patient will receive individualized PN that you currently use. 2) What changes my practice with respect to ordering PN? *If your patient is a candidate for Olimel®, we have no ability to alter its composition – you may need to order additional electrolyte boluses. 3) Who is a candidate for Olimel®? *patients on peripheral PN *stable patients that are near an ideal body weight, and do not have atypical nutritional or electrolyte requirements 4) What is the advantage of Olimel®? *ease of use and preparation *decreased cost Front of Order Form: Back of Order Form:
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