Kabiven/ Kabiven Peripheral

• 3-chamber bag with separate compartments providing a combination of amino acids, lipid, glucose and electrolytes
• Versions available for central and venous peripheral application
• Contains Intralipid - the highly reliable lipid emulsion (see Intralipid for further details regarding benefits)
• Ensures appropriate nutrition for most patients in a single bag
• Convenient, time- and cost saving^1-3
• Extensive compatibility and stability data are available with a wide range of admixtures
• Innovative container: sterile port system, self-sealing ports, stable, easy opening peel seals
• Environmentally-friendly packaging
• Bag is up to 24 months storable at room temperature
• Container: infusion bag for central venous administration (1026/1540/2053 ml) and peripheral venous administration (1440/1920 ml)

References:

1. Raper S et al.,2002
2. Pichard C et al., 2000
3. Ebner C et al., 2002

• Parenteral nutrition in a single bag
• Contains Intralipid - a highly reliable lipid emulsion
• Several bag sizes to meet varying patient requirements
• Convenient, time saving* usability and easy handling
• Storable up to 24 months without refrigeration
• Environmentally-friendly packaging

* Pertkiewicz M, Dudrick SJ 2009

Parenteral nutrition for patients and children above two years of age, when oral or enteral nutrition is impossible, insufficient or contraindicated.

Kabiven Central

The dose should be individualised and the choice of bag size should be made with regard to the patient’s clinical condition, body weight and nutritional requirements.

Adult 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 0.10-0.15 g nitrogen/kg body weight/day in the normal nutritional state or in conditions with mild metabolic stress. In patients with moderate to high metabolic stress with or without malnutrition, the requirements are in the range of 0.15-0.30 g nitrogen/kg body weight/day (1.0-2.0 g amino acid/kg body weight/day). The corresponding commonly accepted requirements are 2.0-6.0 g for glucose and 1.0-2.0 g for fat.

The dose range of 0.10 - 0.20 g nitrogen/kg body weight/day (0.7-1.3 g amino acid/kg body weigh/day) which covers the need of the majority of the patients. This corresponds to 19 ml - 38 ml Kabiven/kg body weight/day. For a 70-kg-patient this is equivalent to 1330 ml - 2660 ml Kabiven per day.

The total energy requirement depends on the patient’s clinical condition and is most often between 25 - 35 kcal/kg body weight/day. In obese patients the dose should be based on the estimated ideal weight.

Kabiven is produced in four sizes intended for patients with high, moderately increased, basal, or low nutritional requirements. To provide total parenteral nutrition, trace elements and vitamins should be given additionally.

Children

The ability to metabolise 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 0.49-0.98 g fat/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 Kabiven 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.

Fat 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 g fat/kg body weight). The recommended infusion period is 12-24 hours.

Maximum daily dose

40 ml/kg bw/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 N/kg/day), 31 kcal/kg/day non-protein energy (3.9 g glucose/kg/day and 1.6 g fat/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.

Kabiven Peripheral

The dose should be individualised and the choice of bag size should be made with regard to

the patient’s clinical condition, body weight and nutritional requirements.

Adult 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 0.10-

0.15 g nitrogen/kg b.w./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

0.15-0.30 g nitrogen/kg b.w./day (1.0-2.0 g amino acid/kg b.w./day). The corresponding

commonly accepted requirements are 2.0-6.0 g for glucose and 1.0-2.0 g for fat.

The total energy requirement depends on the patient’s clinical condition and is often

between 20-30 kcal/kg b.w./day. In obese patients the dose should be based on the

estimated ideal weight.

Kabiven Peripheral is produced in three 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.

The dose range of 0.10-0.15g N/kg b.w./day (0.7-1.0 g amino acid/kg body weigh/day) and

a total energy of 20-30 kcal body weight/day corresponds to approx. 27-40 ml Kabiven

Peripheral/kg b.w./day.

Children

The ability to metabolise 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 0.49-0.98 g fat/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.

SPC 08-337, 2008-12-19 4 (11)

For children over 10 years of age the dosage for adults can be applied.

The use of Kabiven peripheral 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 b.w./h.

Amino acid dosage should not exceed 0.1 g/ kg b.w. /h.

Fat dosage should not provide more than 0.15 g/ kg b.w./h.

The infusion rate should not exceed 3.7 ml/kg b.w./h (corresponding to 0.25 g glucose,

0.09 g amino acids, 0.13 g fet per kg body weight). The recommended infusion period for

individual bags of Kabiven Peripheral is 12-24 hours.

Maximum daily dose

40 ml/kg b.w./day. This is equal to one bag (largest size) to a 64 kg-patient and will

provide 0.96 g amino acids/ kg b.w./day (0.16 g N/ kg b.w./day), 25 kcal/ kg b.w./day nonprotein

energy (2.7 g glucose/ kg b.w./day and 1.4 g fat/ kg b.w./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 into a peripheral or central vein. Infusion may be continued for as

long as required by the patient’s clinical condition.

In order to minimise the risk of thrombophlebitis for peripheral application, daily rotation

of infusion site is recommended.

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