A: To calculate aluminum load:1
1. Aluminum content in mcg/mL X volume used in mL = total aluminum content for each component
2. Add totals for all components to determine total aluminum level
3. Divide total aluminum level by body weight for mcg/kg/day
Levels greater than 4 to 5 mcg/kg/day in patients with impaired kidney function, including premature neonates on TPN, have been associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.2
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References:
1. Perry L. Improving safety of TPNs: Applying new FDA rules. Drug Topics 2003;2:HSE14.
2. FDA Issues Rule on Aluminum in Parenteral Packaging. Pharmaceutical and Medical Packaging News, April 2000. Available at: http://www.devicelink.com/pmpn/archive/00/04/011.html. Accessed February 2004 .
