Clinical Nutrition
Clinical Nutrition
Functional
gastrointestinal tract
Good tolerance to
Enteral Nutrition
Sufficient enteral
nutrient absorption
Sip feeding /
Oral Nutritional
Supplements (ONS)
Tube
feeding
Functional
gastrointestinal tract
Moderate tolerance to
Enteral Nutrition
Parenteral Nutrition
Non-functional
gastrointestinal tract
Poor tolerance to
Enteral Nutrition
Insufficient enteral
nutrient absorption
Total
Parenteral Nutrition
The NuTRIscreen-App:
Clinical Nutrition
Screening /
Assessment
Admission
Documentation
Procurement
of all needed
products
Development
of nutrition
care plan
Evaluation of
home care
setting
Inpatient
Pathway
Monitoring
Discharge Planning
Implementation
of nutrition
care plan
Training of
caregiver
Outpatient
Pathway
Documentation /
Feedback
Reassessment
Monitoring
Parenteral Nutrition
1. Blood sampling
and analysis
2. Input of glucose
value into SpaceControl
Automatic
insulin
application
Automatic calculation of
appropriate insulin rate
and next sampling time
3. Conrmation of
suggested insulin rate
Clinical Nutrition
Modern nutrition therapy involves premixed convenience
solutions or nutrition solutions specially made for the patient.
B. Braun standardized nutrition solutions are suitable for most
enteral and parenteral feeding of patients. This approach offers
signicant benets as it prevents errors in administering the
right therapy during the routine of daily clinical practice.
Standardization also reduces nurses workloads and the total
cost of preparation.
Enteral Nutrition
B. Braun offers standard and special diets for Enteral Nutrition in
glass bottles and bags. For the delivery of Enteral Nutrition solutions, we also offer resealable nutrition bags which have a xed,
attached tube for the Infusomat Space.
Glucose (mmol/l)
20
B. Braun Space
GlucoseControl
Your benets:
n
Enteral Nutrition
15
Parenteral Nutrition
10
Insulin Pump
5
Space Control
User Interface
Time (hours)
Parenteral Nutrition
The steps:
Safety aspect
After adding the additives
to the clear solution, a
visual check is possible.
3-chamber bags
The 3-chamber bags provide different formulations and bag
volumes with amino acids, carbohydrates and fat and are
available with or without electrolytes.
On individual needs trace elements (e.g. Tracutil) and other
micronutrients can be added via the additive port.
NuTRIflex Lipid contains a MCT/LCT lipid emulsion.
NuTRIflex Omega contains MCT/LCT/Omega-3-acid
triglycerides.
NuTRIflex Lipid 3-chamber bag and NuTRIflex Omega 3-chamber bag
(with and without Electrolytes available)
Amino Acid
Lipid
Lipid: MCT/LCT
Omega: MCT/LCT/
Omega-3-acid
triglycerides
Glucose
Glucose
Amino Acid
Port system
n
Low risk for needlestick injuries
n
Easy grip for convenient handling
n
No leakage after removal
n
Stable ports made of hard plastic
n
Self-sealing
User benets
Latex-free
PVC-free
DEHP-free
Parenteral Nutrition
2-chamber bags
Nutriflex
Sterile solution for intravenous
nutrition containing amino
acids, carbohydrates and electrolytes in a 2-chamber bag.
Nutriflex
Parenteral nutrition regimens for individual fat requirements
Supplies electrolytes
NuTRIflex Lipid transfer set
Product range
Nutriflex peri
n
Peripheral Parenteral Nutrition
n
Supplemented nutrition or in combination
with enteral feeding
n
For Low Glucose Nutrition (LGN) Therapy
Nutriflex basal
n
Parenteral Nutrition in situations with basal
nutrition requirements
n
For central venous access
Nutriflex plus
n
Parenteral Nutrition in situations with moderately
increased requirements
n
For central venous access
Nutriflex special
n
Volume-restricted Parenteral Nutrition for ICU patients
n
In situations with high nutritional requirements
All Nutriflex - 2-chamber bags
n
Flexibility to choose and add the fat component
(e.g. Lipoplus1, Lipofundin MCT/LCT2)
Accessories
Nutriflex Transfer Set (Art. No. 212 9043)
n
Light Protection Cover:
Nutriflex 1000 ml (Art. No. 212 9035)
Nutriflex 1500 ml, 2000 ml (Art. No. 211 2112)
n
Composition
1000 ml
Nutriflex
peri
Nutriflex
basal
Nutriflex
plus
Nutriflex
special
Content
peri
basal
plus
1000
2000
1000
2000
1000
2000
1000
1500
40
80
32
64
48.1
96.2
70
105
Nitrogen (g)
5.7
11.4
4.6
9.2
6.8
13.6
10
15
Glucose (g)
80
160
125
250
150
300
240
360
480
960
630
1255
790
1580
1240
1860
Osmolarity (mOsm/l)
900
900
1150
1150
1400
1400
2100
2100
Electrolytes (mmol)
Amino acids
40
32
48
70
Nitrogen*
5.7
4.6
6.8
10.0
Glucose
80
125
150
240
Calcium
2.5
5.0
3.6
7.2
Magnesium
4.0
8.0
5.7
11.4
480
630
790
1240
Phosphate
5.7
11.4
12.8
25.6
20.0
Electrolytes
special
Sodium
27
54
49.9
99.8
37.2
74.2
40.5
60.8
Potassium
15
30
30
60
25
50
25.7
38.6
3.6
7.2
4.1
6.2
5.7
11.4
5.0
7.5
40.0
14.7
22.1
Total energy
kcal
Non-Protein energy
kcal
320
500
600
960
Chloride
31.6
63.2
50
100
35.5
71
49.5
74.3
ml
1000, 2000
1000, 2000
1000, 2000
1000, 1500
Acetate
19.5
39
35
70
22.9
45.8
22
33
Presentations**
* due to the specific amino acid pattern, 14 g N 100 g amino acids; ** may differ from country to country
10
PLEASE NOTE: Additions to Nutriflex may increase (e.g. electrolyte concentrates) or decrease (e.g. lipids) its osmolarity. Vitamins and trace elements should be added just prior to use!
There may be some degradation during shelf life. See manufacturers recommendation. *Not all versions and bag volumes will be marketed in each country.
11
Parenteral Nutrition
3-chamber bags
NuTRIflex Lipid
The right choice can be simple
NuTRIflex Lipid represents a
wide range of 3-chamber bag
versions and sizes, covering
different patient needs from
mild to severe catabolism.
NuTRIflex Lipid products contain MCT/LCT as lipid emulsion
and are availabel for peripheral
and central venous use with
and without electrolytes.
Product range
NuTRIflex Lipid peri
n
For peripheral or central venous access
n
Supplementary nutrition
n
In combination with Enteral Nutrition
n
Low glucose content
NuTRIflex Lipid plus
n
Central venous Parenteral Nutrition for moderately
increased requirements
n
Easy to calculate: 1 ml ~ 1 kcal
NuTRIflex Lipid special
n
If volume-restricted Parenteral Nutrition is required
n
In situations with high nutritional demands
n
625 ml version as ICU starter bag and for combined
Enteral/Parenteral Nutrition
NuTRIflex Lipid special without electrolytes
n
For individualized electrolyte administration
1875 ml
1250 ml
Enteral Nutrition
Accessories
Light Protection Cover:
NuTRIflex Lipid 1250 ml, 1875 ml, 2500 ml
(Art. No. 211 2112)
NuTRIflex Lipid 625 ml (Art. No. 212 9035)
625 ml
Content
Composition 1250 ml
2500 ml
NuTRIex Lipid
peri
1250
1875
plus
2500
1250
1875
special
a)
2500
625
1250
1875
2500
140.1
40
60
80
48
72
96
35.1
70.1
105.1
Nitrogen (g)
5.7
8.6
11.4
6.8
10.2
13.6
10
15
20
Glucose (g)
80
120
160
150
225
300
90
180
270
360
Lipids (g)
50
75
100
50
75
100
25
50
75
100
955
1435
1910
1265
1900
2530
740
1475
2215
2950
Osmolarity (mOsm/l)
840
840
840
1215
1215
1215
1545
1545
1545
1545
134
Electrolytes (mmol)
40
48
70.1
70.1
Sodium
50
75
100
50
75
100
33.5
67
100.5
Nitrogen* (g)
5.7
6.8
10
10
Potassium
30
45
60
35
52.5
70
23.5
47
70.5
94
Glucose (g)
80
150
180
180
Calcium
3.0
4.5
6.0
4.0
6.0
8.0
2.65
5.3
7.95
10.6
50
50
50
50
Magnesium
3.0
4.5
6.0
4.0
6.0
8.0
2.65
5.3
7.95
10.6
Electrolytes
Phosphate
7.5
11.25
15.0
15.0
22.5
30.0
10.0
20.0
30.0
40.0
955
1265
1475
1475
Chloride
48
72
96
45
67.5
90
30
60
90
120
795
1075
1195
1195
Acetate
40
60
80
45
67.5
90
30
60
90
120
0.03
0.045
0.06
0.03
0.045
0.06
0.02
0.04
0.06
0.08
Presentations** (ml)
* due to the specific amino acid pattern, 14 g N 100 g amino acids; ** may differ from country to country
12
Zinc
PLEASE NOTE: Additions to NuTRIflex Lipid may increase its osmolarity. Vitamins and trace elements should be added just prior to use! There may be some degradation during shelf life. See manufacturers recommendation.
a)
NuTRIflex Lipid special also exist as electrolyte-free version (special: 1330 mOsm/l). *Not all versions and bag volumes will be marketed in each country.
13
Parenteral Nutrition
NuTRIflex Omega
Simply Unique
Lipoplus/Lipidem vs. LCT
With electrolytes
25
Lipidem/Lipoplus
LCT (soya oil emulsion)
*p < 0.006
20
Lipid
MCT/LCT/omega-3
*5 days
days
22
15
Glucose
17
10
Amino Acid
0
Modified from Wichmann et al. (2007)
Fatty acid
EPA
DHA
NuTRIflex
Omega plus
NuTRIflex
Omega plus
NuTRIflex
Omega special
NuTRIflex
Omega special
NuTRIflex
Omega special
NuTRIflex
Omega special
Vol
ml
1,250
1,875
2,500
625
1,250
1,875
2,500
Total energy
kcal
1,265
1,900
2,530
740
1,475
2,215
2,950
Total energy
kJ
5,300
7,950
10,600
3,095
6,175
9,265
12,350
140.1
Notation
Lipoplus 20 %
Competitor
20
20:5n3
3.69 0.14
3.03 0.12
Amino acids
48
72
96
35.1
70.1
105.1
22:6n3
2.53 0.14
2.00 0.15
Nitrogen
6.8
10.2
13.6
10
15
20
Glucose
150
225
300
90
180
270
360
Medium chain
triglycerides
25
37.5
50
12.5
25
37.5
50
Soya-bean oil
20
30
40
10
20
30
40
Omega-3 acid
triglycerides
7.5
10
2.5
7.5
10
mmol
50
75
100
33.5
67
100.5
134
22
Electrolytes:
Sodium (Na+)
Benets
Potassium (K )
mmol
35
52.5
70
23.5
47
70.5
94
Magnesium (Mg2+)
mmol
2.65
5.3
7.95
10.6
Calcium (Ca2+)
mmol
2.65
5.3
7.95
10.6
Phosphat
mmol
15
22.5
30
10
20
30
40
Chloride (Cl-)
mmol
45
67.5
90
30
60
90
120
14
NuTRIflex
Omega plus
Carbon
[unit]
Acetate
mmol
45
67.5
90
30
60
90
120
Zinc (Zn2+)
mmol
0.03
0.05
0.06
0.02
0.04
0.06
0.08
Antioxidant:
Additional Vitamin E approx. 200 mg a-tocopherol/L inside!
15
Parenteral Nutrition
Compounding of a
Nutrimix mixing bag
Product range
n Aminoplasmal B. Braun:
Amino acid solutions for Parenteral Nutrition
n Aminoplasmal Hepa:
Amino acid solution for Parenteral Nutrition in severe
liver disease and for the therapy of hepatic encephalopathy
Lipoplus/Lipidem:
Modern fat emulsion based on medium and long
chain triglycerides including -3 fatty acids
n
Lipofundin MCT/LCT 1:
Fat emulsion on the basis of medium and
long chain triglycerides
n
Glucose Braun: Glucose solution for providing energy
n
Tracutil: Trace element additive
n
Nutrimix: EVA mixing bags
n
User benets
Wide range of products
16
17
Parenteral Nutrition
Amino acids
Lipid emulsions
Aminoplasmal B. Braun
Amino acid solution for
Parenteral Nutrition.
Lipofundin MCT/LCT 1
Fat emulsion for Parenteral
Nutrition on the basis of
medium and long chain
triglycerides.
Lipoplus 15
New generation of lipid
emulsion.
Aminoplasmal
Aminoplasmal Hepa
Lipofundin MCT/LCT1
Lipoplus15
Inflammation-modulating effects
- reduced length of hospital stay16,17
- improved oxygenation index17
Characteristics
n
Flexible through concentration range of 5-15%
n
Available with and without electrolytes
n
Electrolyte-free versions chloride-free
Characteristics
n
Amino acid concentration of 10%
n
Amino acid pattern adapted to the specific needs of patients
with severe liver insufficiency2
Amino acids
50
Aminoplasmal B. Braun
10%
10 % E
100
100
Nitrogen
16
Composition
1000 ml
Aminoplasmal B. Braun
5% E
Electrolytes
Energy
Presentations*
* may differ from country to country
18
Aminoplasmal
15 %
15 % E
150
150
Aminoplasmal
Hepa 10 %
24
15.3
100
-
kcal
200
400
600
400
ml
500, 1000
500
Characteristics
n
Registered for use in neonates and children
n
For peripheral and central venous application
n
Excellent stability in TPN admixtures14
1. Trade name in some countries: Medialipide,
Vasolipid
2. Baldermann H. et al. Changes of hepatic morphology during paterteral nutrition with lipid emulsions
containing LCT or MCT/LCT quantifies by ultrasound;
JPEN 1991; 15: 601-603
3. Carpentier YA, et al. Long-term TPN and liver
dysfunction; Clinical Nutrition 8 (1989) 31, special
supplement
4. Kuse ER. et al. Hepatic reticuloendothelial function
during parenteral nutrition including an MCT/LCT or
LCT emulsion after liver transplantation - a doubleblind study; Transpl Int 15 (2002) 272-277
5. Radermacher P. et al. Fat emulsions containing
medium chain triglycerides in patients with sepsis
syndrome: effects on pulmonary hemodynamics and
gas exchange; Intensive Care Med 18 (1992) 231-234
6. Fiaccadori E, et al. Hemodynamic and respiratory
effects of medium-chain and long chain triglyceride
fat emulsions: a prospective, randomized study;
RINPE 15 (1997) 6-14
7. Gelas Pet al. Effect of parenteral medium and longchain triglycerides on lymphocytes subpopulations
and functions in patients with acquired immunodeficiency syndrome: a prospective study; JPEN 22
(1998) 67-71
8. Sedman PC. et al. Effects of different lipid emulsions on lymphocyte function during total parenteral nutrition; Br J Surg 78 (1991) 1396-1399
Characteristics
n
Contains MCT (coconut), LCT (soybean) and -3 acid triglycerides
n
For peripheral and central venous application
n
Excellent stability in all-in-one admixtures18
n
The combination with Nutriflex 2-chamber bag allows quick,
easy and stable preparation of all-in-one regimens
Composition 1000 ml
Soybean oil (LCT)
50
100
80
50
100
100
20
12
12
Glycerol
25
25
25
Total energy
kcal
1022
1908
1910
a-Tocopherol (Vitamin E)
mg
85 20
170 40
190 30
Presentations*
19
Parenteral Nutrition
Mixing bag
Glucose Braun
Glucose solutions for providing
energy (and fluid)
in Parenteral Nutrition.
Nutrimix
Traditional EVA mixing bag for easy and
safe handling.
Tracutil
Trace element additive for
adults. Used as a supplement
in Parenteral Nutrition.
Nutrimix Barrier
Mixing Bag made of Multi-Layer Film to
protect individual TPN preparations from
oxidation.
Nutrimix
Nutrimix Barrier
Glucose Braun
Tracutil
Nutrimix DC
Characteristics
n
Basic component in Parenteral Nutrition
n
Delivers approximately 4 kcal/g glucose
n
Wide range of concentrations available
Composition
1000 ml
Glucose
Energy
Characteristics
n
Balanced mixture of the 9 trace elements Iron, Zinc,
Manganese, Copper, Chromium, Molybdenum,
Selenium, Fluoride and Iodide
n
Meets the daily requirements of essential trace elements
Glucose
g
10%
100
20%
200
30%
300
40%
400
50%
500
70 %
700
kcal
400
800
1200
1600
2000
2800
Presentations*
* may differ from country to country
Composition
Tracutil
Iron
mol/10 ml
35
Zinc
3.3
50
Manganese
0.55
10
Copper
0.76
12
Chromium
0.01
0.2
Molybdenum
0.01
0.1
Selenium
0.02
0.3
Fluoride
0.57
30
Iodide
0.13
Presentation*
* may differ from country to country
20
mg/10 ml
5 x 10 Ampoule
Nutrimix DC
Dual chamber bag
for stable separate
storage of individual TPN preparation.
Presentations*
Volume
Filling lines
Units/Packages
Packages/Carton
Nutrimix 0.2/0
200 ml
25
2112145
Nutrimix 0.5/0
500 ml
25
2112146
Nutrimix 1/0
1000 ml
25
2112147
Nutrimix 2/3
2000 ml
25
2112150
Nutrimix 3/3
3000 ml
25
2112151
3000 ml
25
2112444
2000 ml
25
2112443
1000 ml
40
2112442
500 ml
50
2112441
200 ml
50
2112440
25
2112446
25
2112445
25
2112449
3000 ml
1500 ml
Transfer Set
1
1
1
21
Enteral Nutrition
BCAA
Rich in BCAA
Carbohydrates
Lipids
Rich in MUFA
Rich in protein
Rich in oligopeptides
Low in carbohydrates
With ber
Rich in glutamine
Lactose free
Complex carbohydrates
Protein
1.3
1.5
Glu
MCT
Rich in MCT
Anorexia
Convalescence
n Loss of conciousness
Anorexia
Convalescence
n Loss of conciousness
Key Features
Key Indications
Fluid restrictions
n Chronic wasting
diseases
n Surgery
n
Fluid restrictions
n Chronic wasting
diseases
n Surgery
n
Maldigestion
n Malabsorption
n Pancreas failure
n Jejunal feeding
Impaired lipid
digestion
n Fat malabsorption
n Steatorrhea
Glucose intolerance
Milk protein
intolerance
Milk protein
intolerance
1.5
1.5
10 x
1.3
H2N
Impaired liver
function
n Liver disease
1.3
MCT
Posttraumatic
metabolic condition
n Respiratory failure
1.3
Glu
BCAA
1.3
MCT
MCT
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
g / 1000 ml
% Energy
Protein
38
15
38
15
75
20
75
20
41
16
38
14
39
15
39
16
56
17
66
20
40
12
65
20
Fat
33
30
33
29
50
30
50
29
35
32
11
12
133
54
133
52
44
30
37
24
58
40
58
40
Carboh.
138
55
138
53
188
50
188
48
123
48
188
74
35
31
35
30
170
53
183
54
155
48
130
40
15
20
21
15
< 0.1
13
<6
<1
Fiber
Water
22
840 ml
830 ml
760 ml
750 ml
830 ml
840 ml
840 ml
830 ml
790 ml
780 ml
800 ml
790 ml
23
Enteral Nutrition
Purple color coded for faster
identification
Nutricomp formulas provide the recommended daily requirements of all nutrients by a daily intake of approximately 1500
kcal.
One system for all Enteral Nutrition
application ways
(Enteroport plus)
Hanger
Special
ingredients
Easy opening of
innovative peel seam
Compatibility to all
administration sets
with ENPlus Spike,
Multispike or
Universal Adapter
24
25
Nutricomp Standard
Enteral Nutrition
Product Description
Nutricomp Standard is a normocaloric, nutritionally complete dietary food, enriched
with fish oil, for special medical purposes. It can be used for sip or tube feeding.
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of soy oil, MCT and fish oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 200 mosmol / Osmolality: 240 mosmol / kg
Indications (examples)
n Normal energy needs
n Contraindications to fiber
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
90 g
450 g
Protein
3.8 g
19 g
Vitamin D
1 g
5 g
Fat
3.3 g
16.5 g
Vitamin E
1.5 mg
7.5 mg
13.8 g
69 g
Vitamin K
7 g
35 g
Vitamin B1
0.2 mg
1 mg
84 ml
420 ml
Vitamin B2
0.2 mg
1 mg
Vitamin B6
0.2 mg
1 mg
Vitamin B12
0.3 g
1.5 g
Vitamin C
10 mg
50 mg
1.8 mg
9 mg
30 g
150 g
0.6 mg
3 mg
5 g
25 g
Carbohydrates
Fiber
Water
Minerals
Normocaloric
(1.0 kcal)
100 mg
500 mg
Potassium (K)
150 mg
650 mg
Calcium (Ca)
75 mg
375 mg
Niacin
Magnesium (Mg)
20 mg
100 mg
Folic acid
Phosphorus (P)
65 mg
325 mg
Pantothenic acid
100 mg
500 mg
Biotin
per
100 ml
per
500 ml
Iron (Fe)
1.2 mg
6 mg
Zinc (Zn)
1.2 mg
6 mg
Copper (Cu)
150 g
750 g
13 g
65 g
7 g
35 g
Iodine (I)
Chromium (Cr)
Manganese (Mn)
0.2 mg
1 mg
Molybdenum (Mo)
10 g
50 g
7 g
35 g
Selenium (Se)
26
per
500 ml
Sodium (Na)
Chloride (Cl)
Special features
per
100 ml
per
100 ml
15 %
30 %
55 %
0%
per
500 ml
27
Enteral Nutrition
n
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of soy oil, rape seed oil, MCT
and fish oil
Carbohydrate composition from maltodextrin and resistant starch to provide
a rapid and easily available energy source
Fiber sources from inulin, oat and resistant starch
Low, physiological osmolarity/ osmolality for better compliance:
n Osmolarity: 260 mosmol / Osmolality: 315 mosmol / kg
Indications (examples)
n Normal energy needs
n Regulation of bowel function
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
90 g
450 g
Protein
3.8 g
19 g
Vitamin D
1 g
5 g
Fat
3.3 g
16.5 g
Vitamin E
1.5 mg
7.5 mg
13.8 g
69 g
Vitamin K
7 g
35 g
Fiber
1.5 g
7.5 g
Vitamin B1
0.2 mg
1 mg
Water
83 ml
415 ml
Vitamin B2
0.2 mg
1 mg
Vitamin B6
0.2 mg
1 mg
Vitamin B12
0.3 g
1.5 g
Vitamin C
10 mg
50 mg
1.8 mg
9 mg
30 g
150 g
0.6 mg
3 mg
5 g
25 g
Carbohydrates
Normocaloric
(1.0 kcal)
Minerals
100 mg
500 mg
Potassium (K)
150 mg
750 mg
Calcium (Ca)
75 mg
375 mg
Niacin
Magnesium (Mg)
20 mg
100 mg
Folic acid
Phosphorus (P)
65 mg
325 mg
Pantothenic acid
100 mg
500 mg
Biotin
Special features
6 mg
Zinc (Zn)
1.2 mg
6 mg
Copper (Cu)
150 g
750 g
13 g
65 g
7 g
35 g
Manganese (Mn)
0.2 mg
1 mg
Molybdenum (Mo)
10 g
50 g
7 g
35 g
Iodine (I)
Chromium (Cr)
Selenium (Se)
28
per
500 ml
1.2 mg
per
100 ml
Iron (Fe)
per
500 ml
Sodium (Na)
Chloride (Cl)
Rich in fiber
per
100 ml
per
100 ml
15 %
29 %
53 %
3%
per
500 ml
Nutricomp Standard Fibre
Product Description
Nutricomp Standard Fibre is a normocaloric, nutritionally complete dietary food,
enriched with fish oil, for special medical purposes. It can be used for sip or tube
feeding.
29
Enteral Nutrition
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of rape seed oil, MCT and fish oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 345 mosmol / Osmolality: 450 mosmol / kg
Indications (examples)
n High energy needs
n High protein needs
n Contraindications to fiber
n Fluid restrictions
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
135 g
675 g
Protein
7.5 g
37.5 g
Vitamin D
1.5 g
7.5 g
5g
25 g
Vitamin E
3 mg
15 mg
18.8 g
94 g
Vitamin K
11 g
55 g
Vitamin B1
0.3 mg
1.5 mg
76 ml
380 ml
Vitamin B2
0.3 mg
1.5 mg
Vitamin B6
0.3 mg
1.5 mg
Vitamin B12
0.45 g
2.25 g
Vitamin C
15 mg
75 mg
2.7 mg
13.5 mg
45 g
225 g
Fat
Carbohydrates
Fiber
Water
1.5
High-caloric
(1.5 kcal)
Minerals
150 mg
750 mg
Potassium (K)
225 mg
1125 mg
Calcium (Ca)
112 mg
560 mg
Niacin
Magnesium (Mg)
30 mg
150 mg
Folic acid
Phosphorus (P)
98 mg
490 mg
Pantothenic acid
0.9 mg
4.5 mg
150 mg
750 mg
Biotin
7.5 g
37.5 g
Special features
30
per
500 ml
per
500 ml
Sodium (Na)
Chloride (Cl)
Rich in protein
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.8 mg
9 mg
Zinc (Zn)
1.8 mg
9 mg
Copper (Cu)
225 g
1125 g
Iodine (I)
20 g
100 g
Chromium (Cr)
11 g
55 g
Manganese (Mn)
0.3 mg
1.5 mg
Molybdenum (Mo)
15 g
75 g
Selenium (Se)
11 g
55 g
20 %
30 %
50 %
0%
Nutricomp Energy
Product Description
Nutricomp Energy is a high-caloric, nutritionally complete dietary food, enriched
with fish oil, for special medical purposes. It can be used for sip or tube feeding.
31
Enteral Nutrition
n
n
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of MCT, rape seed oil and fish oil
Carbohydrate composition from maltodextrin and resistant starch to provide
a rapid and easily available energy source
Fiber sources from inulin, resistant starch, cellulose and wheat dextrin
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 440 mosmol / Osmolality: 590 mosmol / kg
Indications (examples)
n High energy and protein needs
n Fluid restrictions
n Regulation of bowel function
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
135 g
675 g
Protein
7.5 g
37.5 g
Vitamin D
1.5 g
7.5 g
5g
25 g
Vitamin E
3 mg
15 mg
18.8 g
94 g
Vitamin K
11 g
55 g
2g
10 g
Vitamin B1
0.3 mg
1.5 mg
75 ml
375 ml
Vitamin B2
0.3 mg
1.5 mg
Vitamin B6
0.3 mg
1.5 mg
Vitamin B12
0.45 g
2.25 g
Vitamin C
15 mg
75 mg
2.7 mg
13.5 mg
45 g
225 g
Fat
Carbohydrates
Fiber
Water
1.5
High-caloric
(1.5 kcal)
Minerals
150 mg
750 mg
Potassium (K)
225 mg
1125 mg
Calcium (Ca)
112 mg
560 mg
Niacin
Magnesium (Mg)
30 mg
150 mg
Folic acid
Phosphorus (P)
98 mg
490 mg
Pantothenic acid
0.9 mg
4.5 mg
150 mg
750 mg
Biotin
7.5 g
37.5 g
Rich in fiber
Rich in protein
32
per
500 ml
per
500 ml
Sodium (Na)
Chloride (Cl)
Special features
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.8 mg
9 mg
Zinc (Zn)
1.8 mg
9 mg
Copper (Cu)
225 g
1125 g
Iodine (I)
20 g
100 g
Chromium (Cr)
11 g
55 g
Manganese (Mn)
0.3 mg
1.5 mg
Molybdenum (Mo)
15 g
75 g
Selenium (Se)
11 g
55 g
20 %
29 %
48 %
3%
Product Description
Nutricomp Energy Fibre is a high-caloric, nutritionally complete dietary food,
enriched with fish oil, for special medical purposes.
33
Product Description
Nutricomp Standard Fibre D is a normocaloric, nutritionally complete dietary food,
enriched with fish oil, for special medical purposes. It can be used for sip or tube
feeding.
n
n
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of sunflower oil, fish oil and
rape seed oil
Carbohydrate composition from tapioca starch
Fiber sources from inulin, soy, resistant starch, cellulose and wheat
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 215 mosmol / Osmolality: 260 mosmol / kg
Indications (examples)
n Glucose intolerance
n Normal energy needs
per
100 ml
per
500 ml
Vitamins
Energy
515kcal / 2160 kJ
Vitamin A
90 g
450 g
Protein
4.1 g
20.5 g
Vitamin D
1 g
5 g
Fat
3.5 g
17.5 g
Vitamin E
1.5 mg
7.5 mg
12.3 g
61.5 g
Vitamin K
7 g
35 g
Fiber
2.1 g
22.05 g
Vitamin B1
0.2 mg
1 mg
Water
83 ml
415 ml
Vitamin B2
0.2 mg
1 mg
Vitamin B6
0.2 mg
1 mg
Vitamin B12
0.3 g
1.5 g
Vitamin C
10 mg
50 mg
1.8 mg
9 mg
30 g
150 g
0.6 mg
3 mg
5 g
25 g
Carbohydrates
Normocaloric
(1.0 kcal)
Minerals
100 mg
500 mg
Potassium (K)
150 mg
750 mg
Calcium (Ca)
75 mg
375 mg
Niacin
Magnesium (Mg)
20 mg
100 mg
Folic acid
Phosphorus (P)
65 mg
325 mg
Pantothenic acid
100 mg
500 mg
Biotin
Rich in fiber
Rich in MUFA
Complex
carbohydrates
34
per
500 ml
Sodium (Na)
Chloride (Cl)
Special features
per
100 ml
Trace Elements
per
100 ml
per
500 ml
Iron (Fe)
1.2 mg
6 mg
Zinc (Zn)
1.2 mg
6 mg
Copper (Cu)
150 g
750 g
Iodine (I)
13 g
65 g
Chromium (Cr)
10 g
50 g
Manganese (Mn)
0.2 mg
1 mg
Rich in antioxidants
Molybdenum (Mo)
10 g
100 g
Selenium (Se)
7 g
35 g
per
100 ml
16 %
31 %
49 %
4%
per
500 ml
35
Nutricomp D
Enteral Nutrition
Enteral Nutrition
per
500 ml
Vitamins
Energy
Vitamin A
50 g
250 g
Protein
3.8 g
19 g
Vitamin D
0.5 g
2.5 g
Fat
1.1 g
5.5 g
Vitamin E
0.7 mg
3.5 mg
18.8 g
94 g
Vitamin K
4.5 g
22.5 g
Fiber
< 0.3 g
< 1.5 g
Vitamin B1
0.1 mg
0.5 mg
Indications (examples)
n Malassimilation syndrome (malabsorption and maldigestion)
n Pancreas failure
n Jejunal feeding
Water
84 ml
420 ml
Vitamin B2
0.1 mg
0.5 mg
Vitamin B6
0.1 mg
0.5 mg
Sodium (Na)
140 mg
700 mg
Vitamin B12
0.3 g
1.5 g
Potassium (K)
120 mg
600 mg
Vitamin C
4.5 mg
22.5 mg
Calcium (Ca)
50 mg
250 mg
Niacin
1.2 mg
6 mg
Magnesium (Mg)
18 mg
90 mg
20 g
100 g
Phosphorus (P)
40 mg
200 mg
Pantothenic acid
0.51 mg
3.55 mg
Chloride (Cl)
96 mg
480 mg
Biotin
5 g
25 g
n
n
High biologic value protein from different protein sources such as whey protein
and soy hydrolysate
Balanced fatty-acid profile from the combination of MCT and soy oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 310 mosmol / Osmolality: 370 mosmol / kg
Key
characteristics
Carbohydrates
Normocaloric
(1.0 kcal)
Rich in
oligopeptides
Minerals
Trace Elements
36
per
100 ml
per
500 ml
per
500 ml
Iron (Fe)
0.9 mg
4.5 mg
Zinc (Zn)
0.75 mg
3.75 mg
100 g
500 g
13 g
65 g
5 g
25 g
0.15 mg
0.75 mg
Copper (Cu)
Special features
per
100 ml
Iodine (I)
Chromium (Cr)
Manganese (Mn)
Molybdenum (Mo)
10 g
50 g
Selenium (Se)
5.7 g
28.5 g
per
100 ml
Folic acid
14 %
12 %
74 %
0%
per
500 ml
Nutricomp Peptid
Product Description
Nutricomp Peptid is a normocaloric, nutritionally complete dietary food, with
protein as defined oligopeptides, for special medical purposes. It can be used for
sip or tube feeding and comes with a slight taste of peppermint.
37
Enteral Nutrition
n
n
n
n
Indications (examples)
n Milk protein intolerance
n Contraindications to fiber
n Normal energy needs
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
90 g
450 g
Protein
3.9 g
19.5 g
Vitamin D
1 g
5 g
Fat
3.5 g
17.5 g
Vitamin E
1.5 mg
7.5 mg
13.3 g
66.5 g
Vitamin K
7 g
35 g
Vitamin B1
0.2 mg
1 mg
84 ml
420 ml
Vitamin B2
0.2 mg
1 mg
Vitamin B6
0.2 mg
1 mg
Vitamin B12
0.3 g
1.5 g
Vitamin C
10 mg
50 mg
1.8 mg
9 mg
30 g
150 g
0.6 mg
3 mg
5 g
25 g
Carbohydrates
Fiber
Water
Normocaloric
(1.0 kcal)
Minerals
80 mg
400 mg
Potassium (K)
133 mg
665 mg
Calcium (Ca)
67 mg
336 mg
Niacin
Magnesium (Mg)
24 mg
120 mg
Folic acid
Phosphorus (P)
50 mg
250 mg
Pantothenic acid
100 mg
500 mg
Biotin
Special features
per
100 ml
per
500 ml
Iron (Fe)
1.2 mg
6 mg
Zinc (Zn)
1.2 mg
6 mg
150 g
750 g
13 g
65 g
7 g
35 g
Manganese (Mn)
0.2 mg
1 mg
Molybdenum (Mo)
10 g
50 g
7 g
35 g
Protein source from soy for patients with milk protein intolerance
Copper (Cu)
Lactose free
Iodine (I)
Chromium (Cr)
Selenium (Se)
38
per
500 ml
Sodium (Na)
Chloride (Cl)
Lactose free
per
100 ml
per
100 ml
15 %
31 %
54 %
0%
per
500 ml
Nutricomp Soy
Product Description
Nutricomp Soy is a normocaloric, nutritionally complete dietary food, with soy
protein, enriched with fish oil, for special medical purposes. It can be used for sip
or tube feeding.
39
Enteral Nutrition
n
n
n
n
n
Indications (examples)
n Milk protein intolerance
n Normal energy needs
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
90 g
450 g
Protein
3.9 g
19.5 g
Vitamin D
1 g
5 g
Fat
3.5 g
17.5 g
Vitamin E
1.5 mg
7.5 mg
13.3 g
66.5 g
Vitamin K
7 g
35 g
Fiber
1.5 g
7.5 g
Vitamin B1
0.2 mg
1 mg
Water
83 ml
415 ml
Vitamin B2
0.2 mg
1 mg
Vitamin B6
0.2 mg
1 mg
Vitamin B12
0.3 g
1.5 g
Vitamin C
10 mg
50 mg
1.8 mg
9 mg
30 g
150 g
0.6 mg
3 mg
5 g
25 g
Carbohydrates
Normocaloric
(1.0 kcal)
Minerals
80 mg
400 mg
Potassium (K)
133 mg
665 mg
Calcium (Ca)
67 mg
336 mg
Niacin
Magnesium (Mg)
24 mg
120 mg
Folic acid
Phosphorus (P)
50 mg
250 mg
Pantothenic acid
100 mg
500 mg
Biotin
Lactose free
40
Special features
n
Protein source from soy for patients with milk protein intolerance
Lactose free
per
500 ml
Sodium (Na)
Chloride (Cl)
Rich in fiber
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.2 mg
6 mg
Zinc (Zn)
1.2 mg
6 mg
Copper (Cu)
150 g
750 g
13 g
65 g
7 g
35 g
Manganese (Mn)
0.2 mg
1 mg
Molybdenum (Mo)
10 g
50 g
7 g
35 g
Iodine (I)
Chromium (Cr)
Selenium (Se)
16 %
30 %
52 %
2%
per
500 ml
41
Product Description
Nutricomp Soy Fibre is a normocaloric, nutritionally complete dietary food, with
soy protein, enriched with fish oil, for special medical purposes. It can be used for
sip or tube feeding.
Enteral Nutrition
Nutricomp MCT
Product Description
Nutricomp MCT is a high-caloric, nutritionally complete dietary food, enriched with
MCT, for special medical purposes. It can be used for sip or tube feeding.
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of MCT and soy oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 334 mosmol / Osmolality: 423 mosmol / kg
Indications (examples)
n Impaired lipid digestion
n Fat malabsorption
n Steatorrhea
n High energy needs
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
117 g
585 g
Protein
5.6 g
28 g
Vitamin D
1.3 g
6.5 g
Fat
4.4 g
22 g
Vitamin E
2 mg
10 mg
Carbohydrates
17 g
85.5 g
Vitamin K
9.1 g
45.5 g
Fiber
< 0.1 g
< 0.1 g
Vitamin B1
0.26 mg
1.3 mg
Water
79 ml
395 ml
Vitamin B2
0.26 mg
1.3 mg
Vitamin B6
0.26 mg
1.3 mg
Vitamin B12
0.39 g
1.95 g
Vitamin C
13 mg
65 mg
2.3 mg
11.5 mg
39 g
195 g
0.78 mg
3.9 mg
6.5 g
32.5 g
1.3
High-caloric
(1.3 kcal)
Minerals
130 mg
650 mg
Potassium (K)
235 mg
1175 mg
Calcium (Ca)
98 mg
490 mg
Niacin
Magnesium (Mg)
26 mg
130 mg
Folic acid
Phosphorus (P)
85 mg
425 mg
Pantothenic acid
130 mg
650 mg
Biotin
Rich in MCT
Trace Elements
Special features
42
per
500 ml
Sodium (Na)
Chloride (Cl)
MCT
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.6 mg
8 mg
Zinc (Zn)
1.6 mg
8 mg
Copper (Cu)
195 g
975 g
Iodine (I)
17 g
85 g
Chromium (Cr)
9.1 g
45.5 g
0.26 mg
1.3 mg
Manganese (Mn)
Molybdenum (Mo)
13 g
65 g
Selenium (Se)
9.1 g
45.5 g
17 %
30 %
53 %
0%
per
500 ml
43
Enteral Nutrition
n
n
High biologic value protein from different protein sources such as casein and
wheat protein hydrolysate
Balanced fatty-acid profile from the combination of MCT, rape seed oil, sunflower
oil and fish oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Fiber composition from fructo-oligosaccharides (FOS), soy and wheat dextrin
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 380 mosmol / Osmolality: 490 mosmol / kg
Indications (examples)
n Impaired immune functions
n Metabolic stress
n Consuming and Inflammatory diseases
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
120 g
600 g
Protein
6.7 g
33.5 g
Vitamin D
1.3 g
6.5 g
Fat
3.7 g
18.5 g
Vitamin E
2 mg
10 mg
18.3 g
91.5 g
Vitamin K
9.3 g
46.5 g
Fiber
1.4 g
7g
Vitamin B1
0.27 mg
1.35 mg
Water
78 ml
390 ml
Vitamin B2
0.27 mg
1.35 mg
Vitamin B6
0.27 mg
1.35 mg
Vitamin B12
0.4 g
2 g
Vitamin C
13 mg
65 mg
2.4 mg
12 mg
40 g
200 g
Carbohydrates
Minerals
per
100 ml
per
500 ml
1.3
High-caloric
(1.3 kcal)
129 mg
645 mg
Potassium (K)
200 mg
1000 mg
Calcium (Ca)
98 mg
490 mg
Niacin
Magnesium (Mg)
27 mg
135 mg
Folic acid
Phosphorus (P)
87 mg
435 mg
Pantothenic acid
0.8 mg
4 mg
133 mg
665 mg
Biotin
6.7 g
33.5 g
Chloride (Cl)
Rich in fish oil
Trace Elements
Rich in fiber
Glu
44
Rich in glutamine
per
100 ml
per
500 ml
Iron (Fe)
1.6 mg
8 mg
Zinc (Zn)
1.6 mg
8 mg
200 g
1000 g
Copper (Cu)
Iodine (I)
17 g
85 g
Chromium (Cr)
9.3 g
46.5 g
0.27 mg
1.35 mg
per
500 ml
Sodium (Na)
Special features
per
100 ml
Rich in antioxidants
Molybdenum (Mo)
13 g
65 g
Selenium (Se)
9.3 g
46.5 g
Manganese (Mn)
20 %
24 %
54 %
2%
Nutricomp Immun
Product Description
Nutricomp Immun is a high-caloric, nutritionally complete dietary food, enriched
with glutamine and fish oil, for special medical purposes. It can be used for sip or
tube feeding and comes in a neutral flavor.
45
Enteral Nutrition
n
n
High biologic value protein from different protein sources such as branched chain
amino acids, casein, whey and cocoa
Balanced fatty-acid profile from the combination of MCT and soy oil
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 395 mosmol / Osmolality: 495 mosmol / kg
Indications (examples)
n Impaired liver function
n Liver disease
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
117 g
585 g
Protein
4g
20 g
Vitamin D
1.3 g
6.5 g
5.8 g
29 g
Vitamin E
2 mg
10 mg
Carbohydrates
15.5 g
77.5 g
Vitamin K
9.1 g
45.5 g
Fiber
0.56 g
2.8 g
Vitamin B1
0.26 mg
1.3 mg
Water
80 ml
400 ml
Vitamin B2
0.26 mg
1.3 mg
Vitamin B6
0.26 mg
1.3 mg
Vitamin B12
0.39 g
1.95 g
Vitamin C
13 mg
65 mg
2.3 mg
11.5 mg
39 g
195 g
0.78 mg
3.9 mg
6.5 g
32.5 g
Fat
1.3
BCAA
High-caloric
(1.3 kcal)
Minerals
91 mg
455 mg
Potassium (K)
156 mg
780 mg
Calcium (Ca)
72 mg
360 mg
Niacin
Magnesium (Mg)
26 mg
130 mg
Folic acid
Phosphorus (P)
60 mg
300 mg
Pantothenic acid
Chloride (Cl)
91 mg
455 mg
Biotin
Rich in BCAA
Rich in MCT
Special features
46
per
500 ml
Sodium (Na)
Trace Elements
MCT
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.6 mg
8 mg
Zinc (Zn)
1.6 mg
8 mg
Copper (Cu)
195 g
975 g
Iodine (I)
17 g
85 g
Chromium (Cr)
9.1 g
45.5 g
0.26 mg
1.3 mg
Molybdenum (Mo)
13 g
65 g
Selenium (Se)
9.1 g
45.5 g
Manganese (Mn)
12 %
40 %
47 %
1%
per
500 ml
Nutricomp Hepa
Product Description
Nutricomp Hepa is a high-caloric, nutritionally complete dietary food, enriched with
BCAA (Branched chain amino acids), for special medical purposes. It can be used for sip
or tube feeding and comes with a chocolate flavor.
47
Enteral Nutrition
n
n
n
High biologic value protein from different protein sources such as casein and soy
Balanced fatty-acid profile from the combination of MCT and soy oils
Carbohydrate composition from maltodextrin to provide a rapid and easily
available energy source
Low, physiological osmolarity / osmolality for better compliance:
n Osmolarity: 335 mosmol / Osmolality: 380 mosmol / kg
Indications (examples)
n Posttraumatic metabolic condition
n Respiratory failure
n Contraindications to fiber
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
117 g
585 g
Protein
6.5 g
32.5 g
Vitamin D
1.3 g
6.5 g
Fat
5.8 g
29 g
Vitamin E
2 mg
10 mg
Carbohydrates
13 g
65 g
Vitamin K
9.1 g
45.5 g
Fiber
< 0.1 g
< 0.1 g
Vitamin B1
0.26 mg
1.3 mg
Water
79 ml
395 ml
Vitamin B2
0.26 mg
1.3 mg
Vitamin B6
0.26 mg
1.3 mg
Vitamin B12
0.39 g
1.95 g
Vitamin C
13 mg
65 mg
2.3 mg
11.5 mg
39 g
195 g
0.78 mg
3.9 mg
6.5 g
32.5 g
1.3
High-caloric
(1.3 kcal)
Minerals
130 mg
650 mg
Potassium (K)
195 mg
975 mg
Calcium (Ca)
98 mg
490 mg
Niacin
Magnesium (Mg)
26 mg
130 mg
Folic acid
Phosphorus (P)
85 mg
425 mg
Pantothenic acid
130 mg
650 mg
Biotin
Rich in MCT
Trace Elements
Low in
carbohydrates
Special features
48
per
500 ml
Sodium (Na)
Chloride (Cl)
MCT
per
100 ml
per
100 ml
per
100 ml
per
500 ml
Iron (Fe)
1.6 mg
8 mg
Zinc (Zn)
1.6 mg
8 mg
Copper (Cu)
195 g
975 g
Iodine (I)
17 g
85 g
Chromium (Cr)
9.1 g
45.5 g
0.26 mg
1.3 mg
Molybdenum (Mo)
13 g
65 g
Selenium (Se)
9.1 g
45.5 g
Manganese (Mn)
per
500 ml
20 %
40 %
40 %
0%
Nutricomp Intensiv
Product Description
Nutricomp Intensiv is a high-caloric, nutritionally complete dietary food, low in
carbohydrates and enriched with MCT, for special medical purposes. It can be used
for sip or tube feeding.
49
Enteral Nutrition
Nutricomp Drink
Nutricomp Drink is an oral nutritional supplement (ONS) or sip feed, which is nutritionally complete and may be used as supplemental or as a sole source of nutrition.
Recommended Daily Dosage
The recommended daily dose of Nutricomp Drink depends on the patient requirements and should be tailored to the patient's specific nutritional needs.
For complete nutrition: 6-7 bottles per day
For supplemental nutrition: 1-3 bottles per day
Product Description
Nutricomp Drink Plus is a high-caloric, nutritionally complete dietary food, enriched
with fish oil, for special medical purposes. Normally it is used for sip feeding and
comes in banana, chocolate, strawberry and vanilla flavors.
n
n
n
n
1.5
High-caloric
(1.5 kcal)
Indications (examples)
n High energy needs
n Fiber contraindicated
per
100 ml
per
500 ml
Vitamins
Energy
Vitamin A
147 g
735 g
Protein
6g
30 g
Vitamin D
1.8 g
9 g
Fat
5g
25 g
Vitamin E
2 mg
10 mg
20 g
100 g
Vitamin K
12 g
60 g
Fiber
< 0.1 g
< 0.5 g
Vitamin B1
0.18 mg
0.9 mg
Water
76 ml
380 ml
Vitamin B2
0.22 mg
1.1 mg
Vitamin B6
0.22 mg
1.1 mg
Vitamin B12
0.55 g
2.75 g
Vitamin C
15 mg
75 mg
2.4 mg
12 mg
45 g
225 g
1.1 mg
5.5 mg
8 g
40 g
Carbohydrates
Minerals
per
500 ml
Sodium (Na)
100 mg
500 mg
Potassium (K)
170 mg
850 mg
Calcium (Ca)
72 mg
360 mg
Niacin
Magnesium (Mg)
27 mg
135 mg
Folic acid
Phosphorus (P)
60 mg
300 mg
Pantothenic acid
115 mg
575 mg
Biotin
Reclosable cap
Chloride (Cl)
Waisted shape
for handy grip
Unbreakable
Special features
n
50
per
100 ml
per
100 ml
Trace Elements
per
100 ml
per
500 ml
Iron (Fe)
1.7 mg
8.5 mg
Zinc (Zn)
1.2 mg
6 mg
Copper (Cu)
170 g
850 g
Iodine (I)
25 g
125 g
Chromium (Cr)
16 g
80 g
0.58 mg
2.9 mg
Molybdenum (Mo)
12 g
60 g
Selenium (Se)
8.3 g
41.5 g
Manganese (Mn)
16 %
30 %
54 %
0%
per
500 ml
51
Enteral Nutrition
As a leader in safe infusion therapy, B. Braun is dedicated to making the administration of Enteral and Parenteral Nutrition safer.
Reported cases of enteral misconnections have resulted in severe
and fatal consequences for patients.
Gravity Systems
B. Brauns ambulatory EN pump for administration
or B. Brauns universal pump for administration
Syringes
One system for all major application
ways and diet containers
Compounded Diets.
Gravity
application
set
ENPlus Port
in bags
ENPlus Port
in Universal
Adapter
ENPlus Port
in empty bags
Purple color coded for faster
identification
Bags
Dedicated enteral connectors eliminate
the possibility of mixing up Parenteral
with Enteral access ports
(Enteroport plus)
52
User benefits
ENPlus Spike
Ambulatory
EN pump
(Enteroport
plus)
male
ENLock
female
ENLock
Connection to patient
Universal
pump
(B. Braun
Space)
53
Enteral Nutrition
Nutrix
Characteristics
Administration set with 1000 or 2500 ml
storage bag
n Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n
Nutrifix FL
Art. no. 9240669
Nutrifix Multispike
Art. no. 9240632
SAFETY Nutrix administration sets
Nutrix
Universal Adapter Safety
Art. no. 9240622
54
Characteristics
Administration set with 1000 ml storage bag
Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n
n
All administration sets are DEHP-free. The step adapter is connectable to tubes with Luer, Luer-Lock, Funnel connector and female
ENLock connector.
55
Enteral Nutrition
Enteroport plus
56
Characteristics
Administration set with 1000 ml storage bag
Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n
n
Characteristics
Administration set with 500, 1000 or
2500 ml storage bag
n Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n
All administration sets are DEHP-free. The step adapter is connectable to tubes with Luer, Luer-Lock, Funnel connector and female
ENLock connector.
57
Enteral Nutrition
Properties
Small, light, handy pumps
Clearly structured display, excellent readability
n Cell phone like intuitive operation
n Automatic free-flow protection when removing
lines
n
n
58
Characteristics
Administration set with 1000 ml storage bag
n Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n DEHP-free
n
Characteristics
Administration set with 1000 ml storage bag
Easy to fill
n Graduated scale and label for patient data
n Roller clamp and drip chamber
n Inverse Safety Y-Port for Omnix Enteral
n Step Adapter
n
n
All administration sets are DEHP-free. The step adapter is connectable to tubes with Luer, Luer-Lock, Funnel connector and female
ENLock connector.
Characteristics
Administration set for exact bolus application
(in connection with Perfusor pump)
n Patient side is connectable with step adapter or
male ENLock adapter
n Container side is connectable with Omnifix
Enteral
n Inner diameter 1,0 mm
n Length 150 cm
n Step Adapter
n PVC-free
59
Enteral Nutrition
SAFETY
60
Characteristics
Omnifix Enteral
5 ml Art. no. 4616005-01
10 ml Art. no. 4616010-01
20 ml Art. no. 4616020-01
50/60 ml Art. no. 4616050-01
Omnifix Enteral
Combi stopper
Art. no. 4495102
STANDARD
Enterofix 1000
Art. no. 9240799
Exadoral
1 ml Art. no. 4608661
2 ml Art. no. 4608662
5 ml Art. no. 4608660
10 ml Art. no. 4608667
20 ml Art. no. 4608663
Characteristics
1000 ml storage/empty bag for fluid application
To be used in connection with all application
sets with a Multispike
n Easy to fill
n Graduated scale and label for patient data
n DEHP-free
Exadoral straw
10 cm Art. no. 4608670
17 cm Art. no. 4608671
n
n
n
n
61
Enteral Nutrition
User benefits
Percutaneous Tubes
n Percutaneous Endoscopic Gastrostomy (PEG)
The tube goes through the skin of the abdomen directly
into the stomach.
n Jejunostomy
The tube goes through the skin of the abdomen directly
into the jejunum.
Dedicated enteral connectors eliminate
the possibility of mixing up Parenteral
with Enteral access ports
PVC tubes
for short-term nasogastric or nasoenteral feeding.
PUR tubes
for long-term nasogastric or nasoenteral feeding.
Purple color coded for faster
identification
One system for all major application
ways and diet containers
No surgery
Short-term or
unknown duration
No risk of
aspiration
and reflux
No stomach
problems
Nasogastral
tube
Long-term duration
Risk of
aspiration
and reflux
Stomach
problems
No surgery
Nasoenteral
tube
No risk of
aspiration
No stomach
problems
PEG
Surgery
Risk of
aspiration
and reflux
Stomach
problems
PEJ
JET-PEG
NCJ
Prolonged requirement
62
63
Enteral Nutrition
Connector
French /
Charriere
Length
Pediatric tube
Nutritub Paed
Art. no. 9246509
LL
CH 6
60 cm
Characteristics
For long term naso-gastric and
naso-intestinal tube feeding.
n
Naso-gastric tubes
Nutritub Gastral
Art. no. 9246517
LL
Nutritub Gastral
Art. no. 9246525
LL / M
Nutritub Gastral
Art. no. 9246533
TR / M
CH 8
CH 8
100 cm
100 cm
n
CH 8
100 cm
n
Nutritub Gastral
Art. no. 9246541
TR / M
Nutritub Gastral T
Art. no. 9246550
TR
CH 12
100 cm
n
CH 15
100 cm
n
Naso-intestinal tubes
Nutritub Intestinal
Art. no. 9246576
TR / M
Nutritub Intestinal
Art. no. 9246584
TR / M
CH 8
CH 12
120 cm
French /
Charriere
Length
Gastric tube
Art. no. 4396057
Gastric tube
Art. no. 4396154
CH 6
50 cm
Gastric tube
Art. no. 4396251
CH 9
50 cm
Gastric tube
Art. no. 4396308
CH 9
100 cm
Gastric tube
Art. no. 4396359
CH 12
50 cm
Gastric tube
Art. no. 4396405
CH 12
100 cm
CH 4.5
Characteristics
For short term use only.
Gastric tube
Art. no. 4396049
38 cm
n
n
CH 4.5
50 cm
n
Radiopaque (stripe)
Luer (L) & funnel (TR)
connector
Gastric tube CH16 equipped
with stylet (Mandrin M)
120 cm
Connector
TR / M
CH 16
80 cm
LL: Luer-Lock, TR: funnel connector, LL / M: Luer-Lock / Mandrin (stylet), TR / M: funnel connector / Mandrin (stylet)
Connector
French/
Charriere
Length
TR
CH 14
122 cm
Characteristics
n
n
n
Duodenal tube
Art. no. 4371160
TR
Duodenal tube
Art. no. 4371186
TR
CH 16
122 cm
n
CH 18
122 cm
64
65
Clinical Nutrition
Aminoplasmal B. Braun
5%E 10% 10 %E
2.50
4.45
2.87
2.03
1.56
3.42
2.20
2.35
2.10
0.80
3.10
5.75
1.50
5.25
6.00
2.80
3.60
2.75
1.15
0.40
5.00
8.90
5.74
4.07
3.12
2.78
4.40
4.70
4.20
1.60
6.20
11.50
3.00
10.50
12.00
5.60
7.20
5.50
2.30
0.40
5.00
8.90
5.74
4.07
3.12
2.78
4.40
4.70
4.20
1.60
6.20
11.50
3.00
10.50
12.00
5.60
7.20
5.50
2.30
0.40
Aminoplasmal-15% /15%E
Composition
Each 1000 ml contains:
Active ingredients (g)
Isoleucine
Leucine
Lysine Monohydrate
(equivalent to Lysine 7.95 g)
Methionine
Phenylalanine
Threonine
Tryptophan
Valine
Arginine
Histidine
Glycine
Alanine
Proline
Aspartic Acid
Acetylcysteine
(equivalent to Cysteine 0.37 g)
Glutamic Acid
Serine
Tyrosine
5.85
11.40
8.93
5.85
11.40
8.93
5.70
5.70
5.40
2.10
7.20
16.05
5.25
19.20
22.35
7.35
7.95
0.50
5.70
5.70
5.40
2.10
7.20
16.05
5.25
19.20
22.35
7.35
7.95
0.50
16.20
3.00
0.50
16.20
3.00
0.50
150g
150g
24.0g
24.0g
600
600
1290
1480
30 mmol 30 mmol
5.5 7.0 5.5 7.0
8.80 g
13.60 g
10.60 g
1.20 g
1.60 g
4.60 g
1.50 g
10.60 g
8.80 g
4.70 g
6.30 g
8.30 g
7.10 g
2.50 g
0.55 g
Acetylcysteine
0.80 g
(equivalent to Cysteine 0.59 g)
Glutamic Acid
5.70 g
Ornithine Hydrochloride
1.66 g
(equivalent to Ornithine 1.35 g)
Serine
3.70 g
Acetyltyrosine
0.86 g
(equivalent to Tyrosine 0.67 g)
Water for Injections
to 1000 ml
Total amino acids
100 g/l
Total nitrogen
15.3 g/l
Caloric value:
1675 kJ/l 400 kcal/l
Osmolarity:
875 mOsm/l
Electrolytes:
Acetate
51 mmol/l
Chloride
10 mmol/l
5 %E 10% 10 %E
50
100
100
8
16
16
200
400
400
588
864
1,021
5.7 6.3 5.7 6.3 5.7 6.3
Electrolytes (mmol)
Sodium
50
-
50
Potassium
25
-
25
Magnesium
2.5 - 2.5
Phosphate
10
-
10
Acetate
35 - 46
Chloride
45 - 52
Therapeutic indications: Supply of substrate for protein synthesis in Parenteral Nutrition.
Contraindication: Severe circulation disorders with vital threat (i.e. shock); Cellular oxygen deficiency
(hypoxia) or acidosis; On account of its amino acid composition, is not to be administered in infants and
children up to the completed 2nd year.
Special warnings and special precautions for use: Aminoplasmal B. Braun 10% should only be administered after careful benefit-risk assessment in the presence of: disorders of amino acid metabolism, hyperhydration, hypokalaemia, hyponatraemia.
Electrolytes (mmol)
Sodium
-
50
Potassium
-
30
Magnesium
- 2,6
Phosphate
-
9,0
Acetate
- 35
Chloride
- 36
Indications: Supply of substrate for protein synthesis in the setting of Parenteral Nutrition.
In Parenteral Nutrition, amino acid infusions should always be accompanied by administration of sufficient
amounts of caloric solutions, e.g. carbohydrate solutions.
Contraindications
Aminoplasmal 15% must not be used when there are
- Disorders of amino acid metabolism;
- Acute renal failure with increased non-protein nitrogen concentrations in the serum;
- Advanced liver disease;
- Acidosis;
- Hyperhydration;
- Hyponatraemia;
- Hypokalaemia;
- Dangerous circulation disorders (shock);
This solution should not be given to neonates, infants, and children up to the completed 2nd year as the
nutrient relations do not properly meet the special paediatric requirements.
Precautions for use and special warnings:
- Individual dosage regimens must be established for patients with hepatic and renal insufficiency.
- Caution is to be exercised in patients with increased serum osmolarity.
- Clinical supervision should include regular checks of fluid balance, serum electrolytes, blood glucose and
acid-base balance.
Contraindications:
- Elevated blood sugar concentration (hyperglycaemia)
- Decreased blood potassium concentration (hypokalaemia)
- High concentration of acid substances in blood (acidosis)
- Hyperhydration
- Simultaneous sodium and water deficiency (hypotonic dehydration)
Special warnings and precautions for use
This solution should only be administered with caution to patients with increased serum osmolarity.
Patient monitoring should include regular checks of the blood glucose level, depending on the
prevailing metabolic condition and the administered dose. Patient monitoring should also include regular
checks of the water balance, the serum electrolyte concentrations in particular serum potassium and
the acid-base balance.
Glucose Infusions should not be administered through the same infusion equipment, simultaneously with,
before, or after administration of blood, because of the possibility of pseudo-agglutination.
Indications:
- Energy supply by means of glucose
- Carbohydrate component in Parenteral Nutrition
- Therapy of hypoglycaemia
B. Braun Melsungen AG
34209 Melsungen, Germany
15% 15 %E
Aminoplasmal
15 % 15 %E
Excipients
Sodium hydroxide, disodium edetate, water for injections
Total amino acids (g)
Total nitrogen (g)
Caloric value (kcal)
Theoretical osmolarity (mOsmol)
Titration acidity (to pH 7.4)
pH
Total amino acids (g)
Total Nitrogen (g)
Caloric value (kcal)
Theoretical osmolarity (mOsmo/L)
pH
Lipofundin MCT/LCT 1
Composition
1000 ml emulsion contain
Lipofundin Lipofundin
MCT/LCT 10% MCT/LCT 20%
Soybean oil
50.0 g
100.0 g
Mediumchain Triglycerides 50.0 g
100.0 g
Glycerol
25.0 g
25.0 g
Egg yolk phospholipids*
8.0 g
12.0 g
Sodium Oleate, a-Tocopherol*, Water for injections
Caloric Value (kcal):
1022
1908
Theor. osmolarity (mOsmo/L) 345
380
pH:
6.5-8.8 6.5-8.5
* The amount of egg yolk phospholipids and
a-tocopherol can vary is some countries. Please
refer to the country representative. Soybean oil is a
refined natural product containing neutral triglycerides of predominantly unsaturated fatty acids.
Medium-chain triglycerides are a mixture of neutral
triglycerides of mainly caprylic (about 60%) and
capric acid (about 40%).
Indications:
Lipofundin MCT/LCT is indicated as a source of
calories and essential fatty acids for patients requiring Parenteral Nutrition.
Contraindications:
The administration of Lipofundin MCT/LCT is contraindicated in patients demonstrating disturbances
in normal fat metabolism such as pathologic hyperlipaemia, lipoid nephrosis, or acute pancreatitis if
accompanied by hyperlipaemia. It is further contraindicated in patients with ketoacidosis or hypoxia, in thromboembolism and in acute shock states.
Precautions for use:
Caution should be exercised in administering intravenous fat emulsions in patients with metabolic
acidosis, severe liver damage, pulmonary disease,
sepsis, diseases of the reticuloendothelial system,
anaemia or blood coagulation disorders or when
there is danger of fat embolism. Administration of
Lipofundin MCT/LCT should be accompanied by
simultaneous carbohydrate infusions making up to
B. Braun Melsungen AG
34209 Melsungen, Germany
B. Braun Melsungen AG
34209 Melsungen, Germany
Indications:
Treatment of hepatic encephalopathy.
Parenteral Nutrition in liver diseases when hepatic encephalopathy is either imminent or already manifest.
Normalisation of amino acid imbalances arising
from severe liver diseases.
Contraindications:
Disturbances of amino acid metabolism of other
than hepatic origin, acidosis, overhydration,
hypokalaemia.
Precautions:
Clinical supervision should include regular checks of
fluid balance and serum electrolytes. Carbohydrates
and electrolytes are to be supplemented as
required. Caution is to be exercised in patients with
hyponatraemia or with increased serum osmolarity.
Unusally rapid infusion rates may produce signs of
intolerance and renal amino acid losses resulting in
amino acid imbalances.
In cases of concurrent renal insufficiency the dos-
Clinical Nutrition
Before infusing a fat emulsion together with other solutions via a Y connector or bypass set, the compatibility of these fluids should be checked, especially when co-administering carrier solutions to which drugs
have been added. Particular caution should be exercised when co-infusing solutions that contain divalent
electrolytes (such as calcium).
The emulsion should always be brought to room temperature prior to infusion.
If filters are used, these must be permeable to fat emulsions.
Serum triglycerides should be monitored during the infusion of Lipoplus. In patients with suspected disorders of lipid metabolism, fasting lipemia should be ruled out before the start of the infusion.
Hypertriglyceridemia 12 hours after the administration of fat is also indicative of abnormal lipid metabolism.
Transient hypertriglyceridemia or elevated blood glucose levels may arise from the patient's metabolic
status. If the plasma triglyceride concentration rises to more than 3 mmol/l during administration of the
fat emulsion, it is recommended to reduce the infusion rate. If the plasma triglyceride concentration still
remains higher than 3 mmol/l, the infusion should be stopped until the plasma triglyceride concentration
normalizes.
Electrolytes, water balance or body weight, acid-base balance, blood glucose levels, and, during long-term
administration, blood counts, coagulation status, and liver function should be monitored.
There is as yet no clinical experience of the use of Lipoplus in children, and there is only limited experience of its use in patients with diabetes mellitus or renal impairment.
There is as yet only limited experience of the use of Lipoplus for periods longer than seven days.
Caution should be exercised in patients with conditions associated with impaired lipid metabolism, such
as renal insufficiency, uncontrolled diabetes mellitus, pancreatitis, hepatic insufficiency, hypothyroidism (in the presence of hypertriglyceridemia), and sepsis.
Lipids may interfere with certain laboratory tests (such as bilirubin, lactate dehydrogenase, oxygen
saturation) when the blood sample is taken before the lipids have been eliminated from the bloodstream.
In most patients this takes 5 to 6 hours beyond the end of the infusion.
The use of fat emulsions as the sole source of calories may give rise to metabolic acidosis. This may be avoided
by the concurrent infusion of carbohydrates. It is therefore recommended to infuse an adequate quantity of
intravenous carbohydrates or an amino acid solution containing carbohydrates along with the fat emulsion.
Vitamin E can interfere with the effect of vitamin K in clotting factor synthesis. This should be borne in
mind in patients with blood clotting disorders or suspected vitamin K deficiency.
Subject to sale by pharmacists only.
B. Braun Melsungen AG
34209 Melsungen, Germany
Nutriflex
Composition
Nutriflex (mixed and ready for use 1000 ml)
Active ingredients
Nutriflex
peri basal plus special
(40/80) (32/125) (48/150) (70/240)
L-isoleucine
2.34 g
1.88 g
2.82 g
4.11 g
L-leucine
3.13 g
2.50 g
3.76 g
5.48 g
L-lysine HCl
2.84 g
2.27 g
3.41 g
4.97 g
(equivalent to L-lysine)
2.27 g
1.82 g
2.73 g
3.98 g
L-methionine
1.96 g
1.56 g
2.35 g
3.42 g
L-phenylalanine
3.51 g
2.81 g
4.21 g
6.15 g
L-threonine
1.82 g
1.45 g
2.18 g
3.18 g
L-tryptophan
0.57 g
0.46 g
0.68 g
1.00 g
L-valine
2.60 g
2.08 g
3.12 g
4.54 g
Arginine glutamate
4.98 g
3.98 g
5.98 g
8.72 g
(equivalent to Arginine
2.70 g
2.16 g
3.24 g
4.73 g
and to Glutamic acid)
2.28 g
1.82 g
2.74 g
3.99 g
1.69 g
1.35 g
2.03 g
2.96 g
L-histidine HCl H2O
(equivalent to Histidine)
1.25 g
1.00 g
1.50 g
2.19 g
L-alanine
4.85 g
3.88 g
5.82 g
8.49 g
L-aspartic acid
1.50 g
1.20 g
1.80 g
2.63 g
L-(+)-glutamic acid
1.22 g
0.98 g
1.47 g
2.15 g
Amino acetic acid
1.65 g
1.32 g
1.98 g
2.89 g
L-proline
3.40 g
2.72 g
4.08 g
5.95 g
L-serine
3.00 g
2.40 g
3.60 g
5.25 g
88.00 g
137.50 g
165.00 g
264.00 g
Glucose H2O
(equivalent to anhydrous glucose)
80.00 g
125.00 g
150.00 g
240.00 g
Sodium chloride
0.17 g
0.37 g
Calcium chloride 2H2O
0.86 g
Magnesium acetate 4H2O
Sodium dihydrogen phosphate 2H2O
Potassium dihydrogen phosphate
0.78 g
1.56 g
Sodium acetate 3H2O
Potassium hydroxide
0.52 g
Sodium hydroxide
0.50 g
Water for injections to
1000 ml
1.40 g
0.53 g
1.23 g
1.74 g
3.20 g
0.96 g
0.10 g
1000 ml
0.53 g
1.23 g
3.12 g
1.56 g
1.40 g
0.23 g
1000 ml
0.60 g
1.08 g
2.00 g
1.63 g
0.62 g
1.14 g
1000 ml
Nutriflex
Total amino acids (g/l)
Total nitrogen (g/l)
Total carbohydrates (g/l)
Total energy kJ/l
(kcal/l)
Non-protein energy kJ/l
(kcal/l)
Osmolarity (mOsm/l)
Electrolytes:
+
Na
K+
Ca++
Mg++
Cl
H2PO4
Acetate
Indication
Parenteral Nutrition.
Contraindications
Nutriflex is contraindicated in cases of hyperglycaemia, disorders of amino acid metabolism, manifest
congestive cardiac failure, untreated shock, overhydration, enhanced plasma potassium levels, acidosis. In
hepatic or renal insufficiency the dosage is to be individually adjusted. Because of the specific composition of the nutrients the use of Nutriflex in newborns, infants and children up to the 2nd year of life is
not recommended.
Precautions
Serum ionogram, water balance, blood glucose levels and acid-base balance are to be monitored. Possible
intolerance reactions (nausea, vomiting, chills) and renal loss of glucose and amino acids with subsequent
amino acid imbalances are due to a too rapid infusion rate.
Adverse reactions
Adverse reactions are not to be expected, and besides have not been reported so far, if contraindications,
dosage recommendations, warnings and precautions are observed.
Subject to sale by pharmacists only.
B. Braun Melsungen AG
34209 Melsungen, Germany
Should the plasma triglyceride concentration remain above 3 mmol/l, the administration should be stopped
until the level normalises. Like all solutions containing carbohydrates, the administration of NuTRIflex
Lipid peri/plus/special/plus without electrolytes/special without electrolytes can lead to hyperglycaemia.
The blood glucose level should be monitored. If there is hyperglycaemia, the rate of infusion should be
reduced or insulin should be administered. If the patient is receiving other intravenous glucose solutions
concurrently, the amount of additionally administered glucose has to be taken into account. An interruption
of administration of the emulsion may be indicated if the blood glucose concentration rises to above
14 mmol/l (250 mg/dl) during administration. Intravenous infusion of amino acids is accompanied by
increased urinary excretion of the trace elements, especially copper and, in particular, zinc. This should be
considered in the dosing of trace elements, especially during long-term intravenous nutrition. Refeeding
or repletion of malnourished or depleted patients may cause hypokalaemia, hypophosphataemia and
hypomagnesaemia. Adequate supplementation of electrolytes according to deviations from normal values
is necessary. NuTRIflex Lipid peri/plus/special/plus without electrolytes/special without electrolytes should
not be given simultaneously with blood in the same infusion set due to the risk of pseudoagglutination.
Elderly patients: Basically the same dosage as for adults applies, but caution should be exercised in patients
suffering from further diseases like cardiac insufficiency or renal insufficiency that may frequently be
associated with advanced age.
Patients with diabetes mellitus, impaired cardiac or renal function: Like all large-volume infusion
solutions, NuTRIflex Lipid peri/plus/special/plus without electrolytes/special without electrolytes should
be administered with caution to patients with impaired cardiac or renal function. There is only limited
experience of its use in patients with diabetes mellitus or renal failure.
Patients with impaired lipid metabolism: NuTRIflex Lipid peri/plus/special/plus without electrolytes/
special without electrolytes should be administered cautiously to patients with disturbances of lipid metabolism, e.g. renal insufficiency, diabetes mellitus, pancreatitis, impaired hepatic function, hypothyroidism
(with hypertriglyceridaemia) and sepsis. If NuTRIflex Lipid peri/plus/special/plus without electrolytes/
special without electrolytes is given to patients with these conditions, monitoring of serum triglycerides
is necessary. The presence of hypertriglyceridaemia 12 hours after lipid administration also indicates
a disturbance of lipid metabolism. Disturbances of the fluid, electrolyte or acid-base balance, must be
corrected before the start of infusion. Controls of the serum electrolytes, the water balance, the acid-base
balance, and during long-term administration of blood cell counts, coagulation status and hepatic
function are necessary. Substitution of electrolytes, vitamins and trace elements may be necessary as
required. As NuTRIflex Lipid peri/plus/special contains zinc and magnesium, care should be taken when it
is coadministered with solutions containing these elements. For NuTRIflex Lipid plus without electrolytes/
special without electrolytes: These products do not contain electrolytes. Therefore sufficient amounts of
electrolytes must be administered together with NuTRIflex Lipid plus without electrolytes/special without
electrolytes according to the patients requirements. A sufficient potassium substitution has to be ensured.
It may be necessary to supply also trace elements and vitamins. Close monitoring of serum electrolytes is
mandatory. This applies especially for refeeding or repletion of malnourished or depleted patients who are
at special risk to develop hypokalaemia, hypophosphataemia and hypomagnesaemia. NuTRIflex Lipid plus
without electrolytes/special without electrolytes contain less than 1 mmol sodium (23 mg) per multichamber
bag, i.e. it is essentially sodium-free.
As with all intravenous solutions strict aseptic precautions are necessary for the infusion of NuTRIflex Lipid
peri/plus/special/plus without electrolytes/special without electrolytes.
Pregnancy and lactation: There are no or limited amount of data from the use of NuTRIflex Lipid peri/
plus/special/plus without electrolytes/special without electrolytes in pregnant women. Animal studies
are insufficient with respect to reproductive toxicity (see section 5.3). Parenteral nutrition may become
necessary during pregnancy. Nutriflex Lipid peri should only be given to pregnant women after careful
consideration. Components/metabolites of NuTRIflex Lipid peri/plus/special/plus without electrolytes/
special without electrolytes are excreted in human milk, but at therapeutic doses no effects on the breastfed newborns/infants are anticipated. Nevertheless, breast-feeding is not recommended for mothers on
parenteral nutrition.
Undesirable effects: The following listing includes a number of systemic reactions that may be associated
with the use of NuTRIflex Lipid peri/plus/special/plus without electrolytes/special without electrolytes.
Under conditions of correct use, in terms of dosing monitoring, observation of safety restrictions and
instructions, most of them are rare (1/10,000 to < 1/1,000).
Undesirable effects are listed according to their frequencies as follows:
Very common ( 1/10)
Common
( 1/100 to < 1/10)
Uncommon ( 1/1,000 to < 1/100)
Rare
( 1/10,000 to < 1/1,000)
Very rare
(< 1/10,000)
Not known (frequency cannot be estimated from the available data)
Blood and lymphatic system disorders: Rare: Hypercoagulation
Immune system disorders: Rare: Allergic reactions (e.g. anaphylactic reactions, dermal eruptions, laryngeal,
oral and facial oedema)
Metabolism and nutrition disorders: Very rare: Hyperlipidaemia, hyperglycaemia, metabolic acidosis, ketoacidosis. The frequency of these undesirable effects is dose-dependent and may be higher under the
condition of absolute or relative lipid overdose.
Nervous system disorders: Rare: Drowsiness
Vascular disorders: Rare: Hypertension or hypotension, flush
Respiratory, thoracic and mediastinal disorders: Rare: Dyspnoea, cyanosis
Gastrointestinal disorders: Uncommon: Nausea, vomiting, loss of appetite
Skin and subcutaneous tissue disorders: Rare: Erythema
General disorders and administration site conditions: Rare: Headache, elevated body temperature, sweating,
feeling cold, chills, pain in the back, bones, chest and lumbar region; Very rare: Fat overload syndrome
NuTRIflex Lipid peri: Common: After a few days, vein irritation, phlebitis or thrombophlebitis may occur.
If signs of vein wall irritation, phlebitis or thrombophlebitis occur, change of the infusion site should be
considered. Should adverse reactions occur or should the triglyceride level rise to above 3 mmol/l during
infusion, the infusion should be stopped or, if necessary, continued at a reduced dosage.
If the infusion is restarted, the patient should be carefully monitored, especially at the beginning, and
serum triglycerides should be determined at short intervals.
B. Braun Melsungen AG, 34209 Melsungen, Germany. Please refer to national approved Summary of
Product Information, before prescribing. Status of latest information: April 2012. Registered Product
information may differ from country to country. Not all products are marketed in all countries.
Clinical Nutrition
Tracutil
Composition
1 ampoule of 10 ml contains
Active ingredients:
6.958 mg
Iron (II) chlorid 4 H2O
(equivalent to 35.0 mol of iron)
Zinc chloride, anhydrous
6.815 mg
(equivalent to 50.0 mol of zinc)
1.979 mg
Manganese (II) chloride 4 H2O
(equivalent to 10.0 mol of manganese)
2.046 mg
Copper (II) chloride 2 H2O
(equivalent to 12.0 mol of copper)
0.053 mg
Chromium (III) chloride 6 H2O
(equivalent to 0.2 mol of chromium)
0.0242 mg
Sodium molybdate 2 H2O
(equivalent to 0.1 mol of molybdenum)
0.0789 mg
Sodium selenite 5 H2O
(equivalent to 0.3 mol of selenium)
Sodium fluoride
1.260 mg
(equivalent to 30.0 mol of fluoride)
Potassium iodide)
0.166 mg
(equivalent to 1.0 mol of iodide)
Excipients:
Hydrochloric acid, water for injections.
Therapeutic indications
Provision of basic trace element requirements
during long-term Parenteral Nutrition in adult
patients.
Contra-indications
Increased serum levels of the trace elements
contained in Tracutil. Tracutil should not be administered to newborn infants, infants and children.
Notes
unstable circulatory status with vital threat (states of collapse and shock), acute phases of cardiac infarction
and stroke, unstable metabolic condition (e.g. severe postaggression syndrome, coma of unknown origin),
inadequate cellular oxygen supply, disturbances of the electrolyte and fluid balance, acute pulmonary
oedema, decompensated cardiac insufficiency.
Special warnings and precautions for use:
Caution should be exercised in cases of increased serum osmolarity. Disturbances of the fluid, electrolyte
or acid-base balance, must be corrected before the start of infusion. Too rapid infusion can lead to fluid
overload with pathological serum electrolyte concentrations, hyperhydration and pulmonary oedema. Any
sign or symptom of anaphylactic reaction (such as fever, shivering, rash or dyspnoea) should lead to immediate
interruption of the infusion. The serum triglyceride concentration should be monitored when infusing
NuTRIflex Omega. Depending on the patients metabolic condition, occasional hypertriglyceridaemia may
occur. If the plasma triglyceride concentration rises to above 3 mmol/l during administration of lipids, it is
recommended that the infusion rate be reduced. Should the plasma triglyceride concentration remain
above 3 mmol/l, the administration should be stopped until the level normalises. Like all solutions containing carbohydrates, the administration of NuTRIflex Omega can lead to hyperglycaemia. The blood
glucose level should be monitored. If there is hyperglycaemia, the rate of infusion should be reduced or
insulin should be administered. If the patient is receiving other intravenous glucose solutions concurrently,
the amount of additionally administered glucose has to be taken into account. An interruption of administration of the emulsion may be indicated if the blood glucose concentration rises to above 14 mmol/l
(250 mg/dl) during administration. Intravenous infusion of amino acids is accompanied by increased urinary
excretion of the trace elements, especially copper and, in particular, zinc. This should be considered in the
dosing of trace elements, especially during long-term intravenous nutrition. Refeeding or repletion of
malnourished or depleted patients may cause hypokalaemia, hypophosphataemia and hypomagnesaemia.
Adequate supplementation of electrolytes according to deviations from normal values is necessary. NuTRIflex
Omega should not be given simultaneously with blood in the same infusion set due to the risk of pseudoagglutination. Controls of the serum electrolytes, the water balance, the acid-base balance and during
long-term administration of blood cell counts, coagulation status and hepatic function are necessary.
Substitution of electrolytes, vitamins and trace elements may be necessary as required. As NuTRIflex
Omega contains zinc and magnesium, care should be taken when it is co-administered with solutions
containing these elements. As with all intravenous solutions strict aseptic precautions are necessary for
the infusion of NuTRIflex Omega. Paediatric population: There is as yet no clinical experience of the use
of NuTRIflex Omega in children and adolescents. Elderly patients: Basically the same dosage as for adults
applies, but caution should be exercised in patients suffering from further diseases like cardiac insufficiency
or renal insufficiency that may frequently be associated with advanced age. Patients with diabetes mellitus,
impaired cardiac or renal function: Like all large-volume infusion solutions, NuTRIflex Omega should be
administered with caution to patients with impaired cardiac or renal function. There is only limited experience of its use in patients with diabetes mellitus or renal failure. Patients with impaired lipid metabolism:
NuTRIflex Omega should be administered cautiously to patients with disturbances of lipid metabolism,
e.g. renal insufficiency, diabetes mellitus, pancreatitis, impaired hepatic function, hypothyroidism (with
hypertriglyceridaemia) and sepsis. If NuTRIflex Omega is given to patients with these conditions, monitoring of serum triglycerides is necessary. The presence of hypertriglyceridaemia 12 hours after lipid
administration also indicates a disturbance of lipid metabolism. Special warnings/precautions regarding
excipients: Vitamin E (a-tocopherol) can interfere with the effect of vitamin K in clotting factor synthesis.
This should be considered in patients with blood coagulation disorders or suspected vitamin K deficiency
and in patients treated with coumarin anticoagulants. Interference with laboratory tests: The fat content
may interfere with certain laboratory measurements (e.g. bilirubin, lactate dehydrogenase, oxygen saturation)
if blood is sampled before fat has been adequately cleared from the blood stream.
B. Braun Melsungen AG, 34209 Melsungen, Germany, Please refer to local Summary of Product
Information, before prescribing. Status of latest information: February 2013
Notes:
Care is to be taken in cases of impaired liver or
kidney function which requires a check of the
serum concentrations and, where appropriate,
reduction of the dose.
Caution is also necessary in case of Wilsons disease
and disturbed iron storage (i.e. haemosiderosis or
haemochromatosis) because copper and iron supplementation may cause an additional accumulation of these elements in such cases.
Special warnings and special precautions for use
In case of biliary tract disease administration of
Tracutil may lead to an accumulation of copper
and manganese. Chromium deficiency leads to a
decrease in glucose tolerance, which improves
again after chromium supplementation. For this
71
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