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Comparative analysis of two different total parenteral nutrition delivery systems


The importance of parenteral nutritional therapy for patients in whom gut feeding is not feasible has been well documented. The main goal in such cases is to correct, maintain and improve patients' nutritional status by choosing an optimal TPN regimen [1].


In this prospective randomized trial we compared the average cost of two different TPN delivery systems - Three Bottle System (TBS) and All In One (AIO) (3) using three compartment NuTRIflex®Lipid bags provided by B|Braun Ltd. We also studied the average time spent for prescription, transcription, preparation and handling of the two regimens.

Patients and methods

Twenty-four patients admitted to our general ICU at the 'PIROGOV' Emergency Institute (1050 beds) and requiring TPN were enrolled in this prospective randomized study. The patients were randomized into two groups. Group 1 (n = 12) received TPN with the standard three bottle system with fat, glucose and aminoacids. Group 2 (n = 12) received TPN with the NuTRIflex®Lipid three compartment bags system. A record of all solutions and disposables was kept and a stopwatch was kept at each bed and each time the TPN needed attention. In addition we interviewed the nurses about their impression working with the two systems.

Result and discussion

The results suggest a big difference in average nursing time (10 min), and cost (1.0-1.17 units) favouring the NuTRIflex®Lipid system. The possibility of less working errors and the reduction of risk from infection also makes it worthwhile. We concluded that the cost/day difference, ergonomic and time saving advantages and well known better tolerance and lower complications risk of three compartment bags system makes it an acceptable and safer TPN regimen.


  1. ASPEN Board of Directors. Guidelines for the use of parenteral and enteral nutrition in adult and pediatric patients. J Parent Ent Nutr 1993, 17: 201-209.

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Milanov, S., Milanov, M. Comparative analysis of two different total parenteral nutrition delivery systems. Crit Care 5 (Suppl 1), P128 (2001).

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