Aminomix 1 Novum

​Double chamber bag: After mixing: 5% amino acids, 20% glucose and the complete electrolyte spectrum

  • Aminomix Novum is a standardized parenteral nutrition formula, designed to meet the daily nutritional requirements of nitrogen (amino acids), glucose, electrolytes and fluid in adult and paediatric patients (>2 yrs) in whom oral or enteral feeding is impossible, insufficient or contraindicated.
  • With its high content of amino acids (50 g per liter) Aminomix Novum suits even the elevated nitrogen requirements of intensive care patients. Total calories provided by Aminomix Novum is 1000kcal.
  • Aminomix Novum contains taurine, which is supposable conditionally essential in critical illness1, trauma2 and sepsis3.
  • The Aminomix Novum nutrition regimen may be complemented by adding a lipid emulsion of choice - in amounts as needed. This allows to flexibly adjust the glucose: lipid ratio of non-protein energy, depending on the individual glucose tolerance of the patient.
  • Aminomix Novum for patients with high energy requirements, good glucose tolerance and normal electrolyte balance. (After mixing: 5% amino acids, 20% glucose and the complete electrolyte spectrum)
  • Container: Aminomix Novum formula is available in infusion bags in (1000 ml). The bag may be stored at room temperature for up to 24 months.
  • Aminomix provides zinc and organic glycerol phosphate.

  • A standard parenteral nutrition preparation is adequate for the majority of patients who need intravenous feeding e.g. after surgery or trauma, patients with sepsis, gastrointestinal disease or short bowel syndrome, during cancer treatment and in many other clinical situations.

Adults (including the elderly) and adolescents older than 14 years of age

Unless otherwise prescribed,

20 ml per kg bodyweight per day

= 1 g amino acid and 4 g glucose/kg bodyweight per day

= 1400 ml/day in a patient weighing 70 kg.
 

Children and adolescents less than 14 years of age

Daily dose for children 2 years and older and less than 5 years of age:

25ml/kg  body weight ~ 1.25 g amino acids and 5 g glucose/kg body weight/day

Daily dose for children 5 years and older and less than 14 years of age:

20ml/kg  body weight ~ 1 g amino acids and 4 g glucose/kg body weight/day

  • Two Chamber Bags (2 CBs) are designed to provide parenteral nutrition admixtures with glucose and amino acids via central administration for primarily adult patients.
  • Amino acids and glucose with and without electrolytes are stored in 2 separate compartments of a plastic bag (2 CB) which is of benefit for the shelf life of the product.
  • Shortly before administration the seals will be opened and the two solutions are mixed.
  • 2 CBs are convenient and safe in handling, providing the flexibility to make additions such as lipid emulsions, trace elements and vitamins. Their variety of nutritional regimens can be used for a wide range of metabolic conditions.
  • Compared to 3 CBs the 2 CBs provide the flexibility to add different lipids.
  • The 2 CB concept has some advantages :
  • It provides flexibility to add varying types and amounts of lipid emulsions according to the patient’s needs, the physicians’ preference and product availability. However, the gain in flexibility results in less convenience compared to 3 CBs. e.g. in case a reduced lipid supply is an option, in case of a continuous sedation with propofol
  • Zinc improves the wound healing is essential for immunity and is needed for a positive nitrogen balance
  • The supply of electrolytes within the formulation of  Aminomix Novum gives the possibility  to reduce the number of manipulations

  1. AKE Recommendations: Enteral and parenteral nutritional support in adults. Austrian Society of Clinical Nutrition 2002
  2. Ahrens CL, Barletta JF, Kanji S, Tyburski JG, Wilson RF, Janisse JJ, Devlin JW. Effect of low-calorie parenteral nutrition on the incidence and severity of hyperglycemia in surgical patients: A randomized, controlled trial. Crit Care Med 2005;33:2507- 2512
  3. A.S.P.E.N. Board of Directors and the Clinical Guidelines Task Force. Guidelines for the use of parenteral and enteral nutrition in adult and paediatric patients. JPEN 2002;26:supplement
  4. Aprili Z, Hauser R, Norlindh T, Kahnemouyi H. Fettleber unter indirekt-kalorimetrisch gesteuerter totaler parenteraler Ernährung. Infusionstherapie 1987; 14: 239 – 44
  5. Baker JP, Lemogne M. Nutritional support in the critically-ill patient: if, when, how, and what. Crit Care Clin 1987;3:97-113 quotient during total parenteral nutrition. JPEN 1983; 7: 1-5
  6. Cahill GF. Starvation in Man. N Eng J Med. 282: 668-675, 1970
  7. Carpentier YA. Parenteral nutrition. In: Sobotka L (Ed). Basics in Clinical Nutrition. Third edition.
  8. Publishing House Galen, 2004
  9. Carpentier YA. Carbohydrates. In: Basics in Clinical Nutrition. Third edition. Publishing House Galen, 2004
  10. Duke JH Jr, Jorgensen SB, Broell JR, Long CL, Kinney JM. Contribution of protein to caloric expenditure following injury. Surgery. 1970 Jul;68(1):168-74
  11. French Speaking Society for Parenteral and Enteral Nutrition. Perioperative artificial nutrition in elective adult surgery. Consensus statement. Clin Nutr 1996;15:223-229
  12. Girlich C. Parenterale Ernährung. Intensivmed 2003;40:71-85
  13. Guenst J, Nelson L. Predictors of total parenteral nutrition-induced lipogenesis. Chest 1994;10:97-105
  14. MacFie J, Nordenström J. Full circle in parenteral nutrition. Clin Nutr. 11: 237-239, 1992
  15. MacFie J. Therapeutic goals to improve outcome. Outlook symposium "Improving Outcomes”, Fresenius Kabi, ESPEN 2001
  16. Nordenström J, Askanazi J, Elwyn DH, et al. Nitrogen balance during total parenteral nutrition: glucose vs fat. Ann Surg, 1983; 197: 27-33
  17. Nordenström J, Thorne A. Benefits and complications of parenteral nutritional support. European Journal of Clinical Nutrition. 48(8): 531-7, 1994
  18. Roth E: Stoffwechsel der Nährsubstrate. In: Handbuch der Infusionstherapie und klinischen Ernährung (Reissigl H, ed), II, Karger 1985, 55-113
  19. Rothkopf MM. Fuel utilization in neoplastic disease: implications for the use of nutrition support in cancer patients. Nutrition 1990; 6S-14S
  20. Sobotka L (Ed). Basics in clinical nutrition. Third edition. Publishing House Galen, 2004
  21. Tappy L, Schwarz JM, Schneiter P, Cayeux C, Revelly JP, Fagerquist CK, Jequier E, Chiolero R. Effects of isoenergetic glucose based or lipid-based parenteral nutrition on glucose metabolism, de novolipogenesis, and respiratory gas exchanges in critically ill patients. Crit Care Med 1998; 26(5):860-7
  22. Van den Berghe G et al. Intensive Insulin therapy in critically ill patients. N Engl J Med 2001;345:1359-67
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  25. Wolfe RR, O’Donnell TF, Stone MD et al. Investigation of factors determining the optimal glucose infusion rate in total parenteral nutrition. Metabolism. 29: 892-900, 1980
  26. Fructose- Sorbitol – Xylitol references:
  27. Heye N;Zimmer C;Terstegge K;Sirtl C;Cervos-Navarro J. Oxalate-induced encephalitis after infusions of sugar surrogates. Intensive Care Med 1991; 17:432-434
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  33. J Neurosurg Anesthesiol 1997; 9:17-20

Nutrients

Requirement per kg BW

1000ML bag

Fluid (ml)

20-40 ml

1000ml

Energy (kcal)

20-30 kcal

1000

Glucose(g)

3-5

200

Amino acids (g)

1-1.5

50

Nitrogen(g)

0.128-0.25

8.2

Lipids (g)

30 to 50 % of non-protein  energy

Lipids can be added if needed

Electrolytes (mmol)

Requirement per day

Content per bag

Sodium

45-145

50

Potassium

30-40

30

Calcium

5-7.5

2

Magnesium

5-10

3

Chloride

45-145

64

Zinc

0.04-0.1

0.04

Phosphate

20-45

15