{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T17:08:40Z","timestamp":1778692120102,"version":"3.51.4"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Hospital pharmacists are essential for the safe use of total parenteral nutrition (TPN), a complex high-alert medication. Errors may occur during TPN administration; for example, Y-site incompatibilities may cause embolism or thrombosis. Pediatric patients are especially vulnerable because of complex formulations and limited venous access. The stability of both TPN and any drugs administered concurrently depends on physicochemical properties. The American Society for Parenteral and Enteral Nutrition emphasizes the pharmacist\u2019s role in preventing such incompatibilities.\nObjective: To describe the role of pharmaceutical care in, and a systematic approach to, managing Y-site administration of medications with TPN in pediatric patients.\nMethods: A prospective observational study was conducted from May to October 2024 at a university children\u2019s hospital in Madrid, Spain. The study involved hospitalized pediatric patients who were receiving TPN by central venous catheter. A clinical pharmacist evaluated the compatibility of IV drugs with TPN using an evidence-based approach, with information from specialized sources and the literature. Each TPN\u2013drug combination was classified as compatible, incompatible, contradictory, or unknown, and pharmacists\u2019 recommendations were documented in the electronic prescription system.\nResults: A total of 37 patients (accounting for 40 TPN episodes) were included. Their median age was 11 (interquartile range 2.9\u201312.8) years, and most were receiving oncological care. Pharmacists undertook 604 interventions; 311 (51.5%) involved compatible combinations, 100 (16.6%) involved incompatible combinations, 150 (24.8%) involved combinations lacking data, and 43 (7.1%) involved combinations with contradictory information. Of the 75 drugs that were reviewed, 25 (33.3%) were compatible with TPN, 15 (20.0%) were incompatible, 32 (42.7%) lacked data, and 3 (4.0%) had contradictory reports.\nConclusions: Pharmacist-led assessment of Y-site compatibility in pediatric TPN is essential for medication safety and good outcomes. The high proportion of drugs with unknown or conflicting information about compatibility highlights the need for further research to support clinical decision-making.\nKeywords: parenteral nutrition, Y-site compatibility, hemato-oncology, pediatrics, pharmaceutical care, medication safety\nR\u00c9SUM\u00c9\nContexte : Les pharmaciens d\u2019h\u00f4pitaux jouent un r\u00f4le essentiel dans l\u2019utilisation s\u00e9curitaire de la nutrition parent\u00e9rale totale (NPT), un m\u00e9dicament complexe \u00e0 haut risque. Des erreurs peuvent en effet survenir lors de l\u2019administration de la NPT; par exemple, des incompatibilit\u00e9s lors de l\u2019administration du m\u00e9dicament en d\u00e9riv\u00e9 (en Y) peuvent provoquer des embolies ou des thromboses. Les patients p\u00e9diatriques sont particuli\u00e8rement vuln\u00e9rables en raison des formulations complexes et d\u2019un acc\u00e8s veineux limit\u00e9. La stabilit\u00e9 de la NPT ainsi que de tout m\u00e9dicament administr\u00e9 en concomitance d\u00e9pend de leurs propri\u00e9t\u00e9s physico-chimiques. L\u2019American Society for Parenteral and Enteral Nutrition souligne l\u2019importance du r\u00f4le du pharmacien dans la pr\u00e9vention de telles incompatibilit\u00e9s.\nObjectif : D\u00e9crire le r\u00f4le des soins pharmaceutiques et une approche syst\u00e9matique de la gestion de l\u2019administration des m\u00e9dicaments en d\u00e9riv\u00e9 chez les patients p\u00e9diatriques avec une NPT.\nM\u00e9thodologie : Une \u00e9tude observationnelle prospective a \u00e9t\u00e9 men\u00e9e de mai \u00e0 octobre 2024 dans un h\u00f4pital universitaire pour enfants \u00e0 Madrid, en Espagne. L\u2019\u00e9tude portait sur des patients p\u00e9diatriques hospitalis\u00e9s avec une NPT par cath\u00e9ter veineux central. Un pharmacien clinicien a \u00e9valu\u00e9 la compatibilit\u00e9 des m\u00e9dicaments administr\u00e9s par voie intraveineuse avec la NPT en adoptant une approche fond\u00e9e sur des donn\u00e9es probantes, en s\u2019appuyant sur des informations provenant de sources sp\u00e9cialis\u00e9es et la litt\u00e9rature scientifique. Chaque association NPT\u2013m\u00e9dicament a \u00e9t\u00e9 class\u00e9e comme compatible, incompatible, contradictoire ou inconnue, et les recommandations des pharmaciens ont \u00e9t\u00e9 document\u00e9es dans le syst\u00e8me de prescription \u00e9lectronique.\nR\u00e9sultats : Au total, 37 patients (repr\u00e9sentant 40 \u00e9pisodes de NPT) ont \u00e9t\u00e9 inclus. Leur \u00e2ge m\u00e9dian \u00e9tait de 11 ans (intervalle interquartile 2,9\u201312,8) et la majorit\u00e9 recevait des soins oncologiques. Les pharmaciens ont r\u00e9alis\u00e9 604 interventions : 311 (51,5 %) concernaient des combinaisons compatibles, 100 (16,6 %) des combinaisons incompatibles, 150 (24,8 %) des combinaisons pour lesquelles il manquait des donn\u00e9es, et des informations contradictoires \u00e9taient impliqu\u00e9es dans 43 interventions (7,1 %). Parmi les 75 m\u00e9dicaments examin\u00e9s, 25 (33,3 %) \u00e9taient compatibles avec la NPT, 15 (20,0 %) ne l\u2019\u00e9taient pas, 32 (42,7 %) \u00e9taient d\u00e9pourvus de donn\u00e9es, et les rapports \u00e9taient contradictoires dans 3 cas (4,0 %).\nConclusions : L\u2019\u00e9valuation dirig\u00e9e par les pharmaciens de la compatibilit\u00e9 de l\u2019administration des m\u00e9dicaments en d\u00e9riv\u00e9 (en Y) chez les patients p\u00e9diatriques ayant une NPT est essentielle pour l\u2019innocuit\u00e9 des m\u00e9dicaments et de bons r\u00e9sultats cliniques. La part \u00e9lev\u00e9e de m\u00e9dicaments dont les informations sur la compatibilit\u00e9 sont inconnues ou contradictoires souligne la n\u00e9cessit\u00e9 de poursuivre les recherches afin de soutenir la prise de d\u00e9cision clinique.\nMots-cl\u00e9s : nutrition parent\u00e9rale, compatibilit\u00e9 en Y, h\u00e9mato-oncologie, p\u00e9diatrie, soins pharmaceutiques, innocuit\u00e9 des m\u00e9dicaments<\/jats:p>","DOI":"10.4212\/cjhp.3903","type":"journal-article","created":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:08:32Z","timestamp":1778688512000},"source":"Crossref","is-referenced-by-count":0,"title":["Pharmacist-Led Assessment of Y-Site Compatibility in Pediatric Total Parenteral Nutrition: A Prospective Study of Clinical Practice"],"prefix":"10.4212","volume":"79","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9768-5359","authenticated-orcid":false,"given":"Beatriz","family":"Leal Pino","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-4949-9322","authenticated-orcid":false,"given":"Bel\u00e9n","family":"Riva de la Hoz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-0340-6489","authenticated-orcid":false,"given":"Marta","family":"Ech\u00e1varri de Miguel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0003-4768","authenticated-orcid":false,"given":"Esther","family":"Algarra S\u00e1nchez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3799-2985","authenticated-orcid":false,"given":"Isabel","family":"Garc\u00eda L\u00f3pez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2026,5,13]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3903\/5877","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3903\/5881","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3903\/5877","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T16:08:34Z","timestamp":1778688514000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,13]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,4,8]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3903","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"value":"1920-2903","type":"electronic"},{"value":"0008-4123","type":"print"}],"subject":[],"published":{"date-parts":[[2026,5,13]]},"article-number":"e3903"}}