Combiflex Lipid Central/Combiflex Lipid Peri Dosage/Direction for Use

The dose should be individualized and the choice of bag size should be made with regard to patient's clinical condition, body weight and nutritional requirements.
Adults patients: The nitrogen requirements for maintenance of body protein mass depend on the patient's condition (e.g. nutritional state and degree of catabolic stress). The requirements are 0.1-0.15 g nitrogen/Kg body weight/day in the normal nutritional state. In patients with moderate to high metabolic stress with or without malnutrition, the requirements are in the range of 0.15-0.3 g nitrogen/Kg body weight/day (1-2 amino acid/Kg body weight/day). The corresponding commonly accepted requirements are 2-6 g for glucose and 1-2 g for fat.
Combiflex Lipid Central: The dose range of 0.1-0.2 g nitrogen/Kg body weight/day (0.7-1.3 g amino acid/Kg body weight/day) which covers the need of the majority of patients. This corresponds to 19 mL-38 mL Lipid Emulsion/Amino Acids/ Electrolytes/Glucose (Combiflex Lipid Central)/Kg body weight/day. For a 70-Kg patient, this is equivalent to 1330 mL-2660 mL Lipid Emulsion/Amino Acids/Electrolytes/Glucose (Combiflex Lipid Central) per day.
The total energy requirement depends on patient's clinical condition and is often between 25-35 kcal/Kg body weight/day. In obese patients the dose should be based on the estimated ideal weight.
Lipid Emulsion/Amino Acids/Electrolytes/Glucose (Combiflex Lipid Central) is produced in two sizes intended for patients with moderately increased, basal or low nutritional requirements. To provide total parenteral nutrition, the addition of trace elements, vitamins and supplemental electrolytes may be required.
Children: The ability to metabolize individual nutrients must determine the dosage.
In general the infusion for small children (2-10 years) should start with a low dose i.e. 12.5-25 mL/Kg (corresponding to 0.48-0.98 g lipid/Kg/day, 0.41-0.83 g amino acids/Kg/day and 1.2-2.4 g glucose/Kg/day) and increased by 10-15 mL/Kg/day up to maximum dosage of 40 mL/Kg/day.
For children over 10 years of age the dosage for adults can be applied. The use of Lipid Emulsion/Amino Acids/Electrolytes/Glucose (Combiflex Lipid Central) is not recommended in children under 2 years of age in whom the amino acid cysteine may be considered conditionally essential.
Infusion rate: The maximum infusion rate for glucose is 0.25 g/Kg/h.
Amino acid dosage should not exceed 0.1 g/Kg/h.
Lipid dosage should not provide more than 0.15 g/Kg/h.
The infusion rate should not exceed 2.6 mL/Kg body weight/hour (corresponding to 0.25 g glucose, 0.09 g amino acid and 0.1 lipid/Kg body weight). The recommended infusion period is 12-24 hours.
Maximum daily dose: 40 mL/Kg body weight/day. This is equal to one bag (largest size) to a 64 Kg-patient and will provide 1.3 g amino acids/Kg/day (0.21 g nitrogen/Kg/day), 31 kcal/Kg/day non-protein energy (3.9 g glucose/Kg/day and 1.6 lipid/Kg/day).
The maximum daily dose varies with the clinical condition of the patient and may even change from day to day.
Method and duration of administration: Intravenous infusion only into a central vein. Infusion may be continued for as long as required by the patient's clinical condition.
Combiflex Lipid Peri: The dosage range of 0.10-0.15 g nitrogen/Kg body weight/day (0.7-1.0 g amino acid/Kg body weight/day) and a total energy of 20-30 kcal body weight/day corresponds to approx. 27-40 mL/Kg body weight per day.
The total energy requirement depends on patient's clinical condition and is often between 20-30 kcal/Kg body weight/day. In obese patients the dose should be based on the estimated ideal weight.
Lipid Emulsion/Amino Acids/Electrolytes/Glucose (Combiflex Lipid Peri) is produced in two sizes intended for patients with moderately increased, basal or low nutritional requirements. To provide total parenteral nutrition, the addition of trace elements, vitamins and supplemental electrolytes may be required.
Children: The ability to metabolize individual nutrients must determine the dosage.
In general the infusion for small children (2-10 years) should start with a low dose i.e. 14-28 mL/Kg (corresponding to 0.48-0.98 g lipid/Kg/day, 0.34-0.67 g amino acids/Kg/day and 0.95-1.9 g glucose/Kg/day) and increased by 10-15 mL/Kg/day up to maximum dosage of 40 mL/Kg/day.
For children over 10 years of age the dosage for adults can be applied. The use of Lipid Emulsion/Amino Acids/Electrolytes/Glucose (Combiflex Lipid Peri) is not recommended in children under 2 years of age in whom the amino acid cysteine may be considered conditionally essential.
Infusion rate: The maximum infusion rate for glucose is 0.25 g/Kg body weight/h. Amino acid dosage should not exceed 0.1 g/Kg body weight/h. Lipid dosage should not provide more than 0.15 g/Kg/h.
The infusion rate should not exceed 3.7 mL/Kg body weight/hour (corresponding to 0.25 g glucose, 0.09 g amino acid and 0.13 lipid per Kg body weight). The recommended infusion period is 12-24 hours. Intravenous infusion into a peripheral or central vein. Infusion may be continued as long as required by patient's clinical condition. In order to minimize the risk of thrombophlebitis for peripheral application, daily rotation of infusion site is recommended.