Erin asked
So, my daughter is 4 years old and is tpn dependant.. we recently changed her amino acids in the tpn from travasol to trophamine.. since the change, her tpn appeared to be carbonated which I found very strange.. what does this mean?
Answer
Trophamine contains a unique amino acid profile and is considered a specialty amino acid, whereas Travasol is considered a standard amino acid formula. Both of these formulas provide both essential and nonessential amino acids which are critical in synthesizing protein in the body. The Trophamine formula is designed to match the amino acid profile of a breast-fed infant, but is commonly used for a variety of pediatric patients whose nutritional needs are not met with standard formulas like Travasol.
The amino acid profile of Trophamine differs significantly from Travasol and allows for a normalized amino acid concentration. Because of this difference in amino acid concentrations, you may notice a difference in the appearance of the two formulas, however, this does not necessarily account for an increase in air bubbles, or carbonation.
Air bubbles could also be caused by the infusion mechanism and could be a cause for concern if significant amount of air is in the line. Generally, priming the line prior to infusion prevents an air embolism, or gas blockage in the vein.
Due to the recent hurricane damage in Puerto Rico, several
amino acid formulas are currently on national
shortage, including Travasol. The product manufacturer relies on
manufacturing plants in Puerto Rico that were severely impacted by the
hurricanes. This could lead to substitution of formulas on a temporary basis to
make it through this crisis. At this time, it does not appear that Trophamine
production has been impacted, but don’t be afraid to clarify any changes with
your doctor or pharmacist.
