Josep M. Suñé i Negre

Selección de emulsiones lipídicas en nutrición parenteral: parámetros bioquímicos y hematológicos

INTRODUCTION Lipid emulsions (LE) are a component of parenteral nutrition (PN) and its fatty acid (FA) profile determines various physiological responses. OBJECTIVES To assess the adequacy of a clinical not restricted protocol in the choice of LE by studying complementary biochemical and hematological parameters (BHP) at the beginning of the PN. METHODS A 4-year retrospective observational study of LE administered to patients with PN. Demographic, clinical, nutritional and analytical variables at the beginning of the PN were collected. Univariate and multivariate analyses were performed to study the correlation between the initial clinical and biochemical parameters and the LE profile used. RESULTS Four hundred and sixty patients (29.5%) out of 1,558 had BHP at the beginning of PN and used mainly the LE combinations soybean (SO) + medium-chain triglycerides (MCT) + olive (OO) + fish (FO) (37.4%) and SO + MCT + OO (35.6%). Statistically significant differences on the LE pattern were observed between patients with and those without initial BHP (44.8% vs39.5% received FO, respectively). Conditions regularly associated with elevated C-reactive protein (CRP) were associated with increased use of FO LE: SO+OO+FO (OR: 4.52 [95% CI: 1.43-13.91]) and SO+MCT+OO+FO (OR: 3.34 [95% CI: 2.10-5.33]). In those complex conditions related with the critical patient MCT were used: hepatic failure (SO+MCT OR: 2.42 [95% CI: 1.03-5.68]) and renal failure (SO+MCT+FO OR: 3.34 [95% CI: 1.12-9.99]). CONCLUSIONS The use of BHP at the beginning of PN treatment allows complementing the clinical and metabolic criteria in LE selection.

New SeDeM-ODT expert system: an expert system for formulation of orodispersible tablets obtained by direct compression

Abstract: SeDeM-ODT expert system is an innovative tool for predicting whether or not an excipient or mixture of powders containing API and excipients is suitable to obtain a buccal dispersible tablet by direct compression. This preformulation tool identifies the index of good compressibility and orodispersibility (IGCB index), unique to each powder or mixture of powders and based on the SeDeM expert system. The IGCB index indicates if a mixture of powder can be compressed by direct compression and, at the same time, indicates if the resulting tablets would be suitable for use as orodispersible tablets. SeDeM ODT and SeDeM expert systems are excellent tools to optimize tablet fabrication. These tools allow a reduction in the number of unnecessary experiments in the laboratory because they provide information on rheology, compactibility properties, etc. In addition, these tools also provide information that can be used for a better understanding of the formulation design.