Compatibility of parenteral nutrition solutions with intravenous medication in infants and children: A literature review.

Evidence and data supporting the co-administration of intravenous medication (IVM) and parenteral nutrition solutions (PNS) is scarce. However, co-administration is often unavoidable practice in paediatric patients and particularly neonates, where secured vascular access can be challenging. This is especially the case when multiple infusions must run simultaneously with limited intravenous access. Safe co-administration could offer a solution to challenges such as fluid restriction and provision of uninterrupted nutritional support. The American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.) guidelines state that "the co-administration could be possible only if guided by supportive data on physicochemical compatibility and stability", which is neither available nor agreed internationally. This systematic review was conducted to address the deficit in compatibility data on commonly used IVMs and PNS in paediatrics and neonates.