How to Prepare SmofKabiven for Safe Infusion

Strict aseptic technique is essential when preparing parenteral nutrition (PN) products like SmofKabiven to prevent potentially life-threatening infections. This three-chamber bag, which contains amino acids, glucose, and lipids, must be correctly activated to ensure the contents are fully combined into a single, homogenous emulsion before administration.

Quick Summary

This guide details the process for activating and preparing a SmofKabiven bag, including essential safety checks, aseptic handling, and properly mixing the contents before infusion.

Key Points

• Aseptic Handling: Always use strict aseptic technique to prevent infection during preparation and administration.

• Inspect the Bag: Before use, check the overpouch for damage and verify the contents are not discolored or separated.

• Roll to Mix: Activate the bag by rolling it firmly from the handle towards the ports to break the internal seals.

• Invert for Homogeneity: Once seals are broken, invert the bag at least three times to ensure the components are fully mixed.

• Add Supplements Carefully: Use the white port to aseptically inject any compatible additives, mixing thoroughly after each addition.

• Spike the Blue Port: Attach the infusion set using the blue port and hang the bag by its dedicated hole.

• Discard After Use: SmofKabiven is for single use only, and any remaining solution must be discarded.

Essential Safety Checks Before You Begin

Patient safety is the absolute priority when handling medical products like SmofKabiven, which should be done by qualified medical staff under strict aseptic conditions.

Pre-Preparation Checklist

• Verify the Prescription: Confirm the correct formulation and volume are prescribed.
• Inspect the Packaging: Check the overpouch and oxygen absorber for damage. Discard if compromised.
• Examine the Solutions: Amino acid and glucose solutions should be clear; the lipid emulsion white and homogenous. Do not use if discolored or separated.
• Check the Expiry Date: Ensure the bag is not expired.
• Ensure Aseptic Environment: Work in a clean area, wash hands, and wear sterile gloves.

The Step-by-Step SmofKabiven Mixing Process

Proper activation ensures all three nutritional components are evenly distributed.

Detailed Mixing Instructions

1. Remove the Overpouch: Tear from the notch, remove, and discard with the oxygen absorber.
2. Break the Seals: Lay the bag flat with ports away. Roll firmly from the handle side towards the ports. Pressure breaks the vertical seals, releasing contents.
3. Mix Thoroughly: Invert the bag at least three times until a homogenous, opaque, white emulsion is achieved.

Adding Supplements to SmofKabiven

Supplements are often added aseptically to the activated, mixed bag.

How to Add Additives Aseptically

1. Prepare the Additive Port: Break off the white additive port's arrow flag.
2. Inject the Additive: Hold the port base, insert the needle into the center, and inject.
3. Mix Again: Invert the bag thoroughly at least three times after each addition.

Connecting the Infusion Set

Follow these steps to connect the bag for infusion.

Infusion Set Connection Steps

1. Prepare the Infusion Port: Break off the blue infusion port's arrow flag.
2. Insert the Spike: Hold the port base and push the infusion set spike fully into the port.
3. Hang the Bag: Use the hole below the handle.
4. Prime the Line: Use a non-vented set or close the air inlet on a vented set. Prime to remove air before connecting to the patient.

SmofKabiven Preparation vs. Storage Timeline

Process/Timeline	Preparation Steps	Post-Mixing Storage & Use	Notes
Preparation	1. Remove overpouch. Tear at notch.	Immediately	Discard oxygen absorber.
	2. Break seals. Roll from handle to ports.	Use immediately.	Consult storage guidelines if not used.
	3. Mix contents. Invert three times until homogenous.	Use within 24 hours at 2-8°C.	For mixed-only bags under aseptic conditions.
	4. Add supplements (optional). Inject through white port, mix after each.	Use within 24 hours at 2-8°C.	Shelf-life is shortened after adding supplements.
Administration	5. Attach infusion set. Spike blue port and hang.	Continuous infusion.	Recommended period is 12-24 hours.
	6. Prime the line. Remove air before patient connection.	Single use only.	Discard any remaining solution.

Summary of Proper SmofKabiven Preparation

Proper SmofKabiven preparation requires strict adherence to aseptic techniques. Key steps include initial safety checks of the bag and contents, activating the bag by breaking internal seals, thorough mixing to create a homogenous emulsion, aseptic addition of any supplements, and correct connection of the infusion set. This minimizes contamination risks and ensures safe administration, and should only be performed by trained healthcare professionals.

Conclusion

Correctly preparing SmofKabiven is vital for safe parenteral nutrition delivery. Following the detailed steps from inspection to infusion set connection, while maintaining aseptic technique, ensures the product is sterile and effective. Mastering this procedure guarantees patients receive essential nutrients safely. Visit the official manufacturer website for more product information.

Aseptic Technique Best Practices

• Use a clean, dedicated preparation area.
• Wear sterile gloves and change if needed.
• Disinfect all port entry points before use.
• Minimize air exposure.
• Discard all components after single use.

Post-Infusion Monitoring

Monitor the infusion rate and watch for adverse reactions like fever or allergic reactions. Stop infusion and contact a doctor if side effects occur.

Important Considerations

• Patient Specifics: Dosage and rates are individualized.
• Storage: Store in overpouch, protected from freezing.
• Disposal: Discard unused solution properly after infusion.

Frequently Asked Questions

What does a properly mixed SmofKabiven bag look like?

After mixing, the contents of the bag should be a homogenous, opaque, white emulsion. If there is any phase separation, discoloration, or visible particles, the bag should not be used.

How do I add other medications or supplements to SmofKabiven?

Supplements should be added aseptically to the activated bag through the white additive port. Use a sterile needle and syringe, inject the supplement, and invert the bag multiple times to ensure thorough mixing.

What should I do if the SmofKabiven bag looks damaged?

Do not use any bag if the overpouch is damaged, the bag itself is punctured, or the integrity of the seals is compromised. Discard the bag and obtain a new, undamaged one.

How long can a mixed SmofKabiven bag be stored?

After mixing, the bag should be used immediately. If stored, and assuming strict aseptic conditions during mixing, it can typically be stored for up to 24 hours under refrigeration (2-8°C). The addition of supplements can further impact this duration.

Can I use a vented infusion set with SmofKabiven?

If using a vented infusion set, the air-inlet must be closed. Otherwise, a non-vented set is recommended.

What is the importance of aseptic technique when preparing SmofKabiven?

Aseptic technique is critical to prevent the introduction of bacteria or other contaminants into the bag, which could cause a serious infection when infused intravenously into the patient.

What should be monitored during a SmofKabiven infusion?

Patient monitoring is key and should include watching for adverse reactions like fever or allergic symptoms. Regular monitoring of serum glucose, electrolytes, and triglyceride levels is also necessary.