Farmacja Polska (Jun 2023)
A comparative review of Baxter ExactaMix 2400 and Fresenius KabiHelp Parenteral Nutrition Compounder Devices
Abstract
Subject of research Parenteral nutrition is a process of feeding nutrients to patients via the intravenous route. It can be classified as total parenteral nutrition (TPN) when patient’s body needs to receive all essential nutrients by this route, and supplemental parenteral nutrition (SPN) when the patient’s intake of nutrients is possible at a limited level. Parenteral nutrition plays a crucial part in the treatment of many disorders e.g., catabolic states, malnutrition and immaturity of gastrointestinal system in infants. The preparation of parenteral nutrition mixtures takes place in hospital pharmacies where they can be composed manually or with the use of specialised compounder devices. Aim The study compared the functionality between two compounders: Baxter ExactaMix 2400 and Fresenius KabiHelp. The study focused on aspects such as: preparation and launch time of the compounders, number of correctly prepared bags, sterility of manufactured bags and used software. Material and methods To compare the duration of preparation and launch time, three measurements for each device were conducted. The assessment of the number of correctly prepared bags was obtained by the subsequent observation of the preparation of 30 parenteral nutrition bags on each compounder. The number of correctly composed bags was assessed by the analysis of deviation in the measured weight of the final bag. The sterility tests were conducted for both devices to determine if they manufacture microbiologically safe bags. The software stability was determined by the number of errors displayed during the production process. The comparison also involved the number of software language versions, graphical differences, available options, type of displayed information and used operating systems. Results The preparation and launch time of the both compounders resulted in no significant difference (p = 0.742) between the devices. In respect of the number of correctly prepared bags (n = 30), Fresenius KabiHelp reached the number of 27 and Baxter ExactaMix 2400 ended with 24 properly composed parenteral nutrition bags, which was not statistically significant (p = 0.721). The results for sterility test were successful for both compounders. Moreover, no significant difference was recognised in relation to software stability (p = 0.326), because Baxter ExactaMix 2400 displayed one error and Fresenius KabiHelp none. Software of the devices differs graphically but allows access to the same options and provide the same type of information. There was a difference between used operating systems and compounders’ available language versions: Fresenius KabiHelp offers eight of them and Baxter ExactaMix 2400 one. Conclusions The results of the study conclude that Fresenius KabiHelp and Baxter ExactaMix 2400 can be both perceived as reliable compounders that can be used for preparation of parenteral nutrition mixtures. There were no superiorities between devices’ preparation and launch time, number of correctly prepared bags, sterility of their work and software stability. Although graphically different, in both cases software provided the same options and information. Each compounder used different operating system. There was also a distinction in the number of available language versions: Fresenius KabiHelp offers eight of them and Baxter ExactaMix 2400 one.
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