NIRMIX CENTRAL:
Combipack of:
1. Amino acids (10% w/v) with Electrolytes for Intravenous infusion (NIRMIN 10 PLUS)
2. Glucose intravenous Infusion BP (30 % w/v)
3. Intravenous Fat emulsion with medium and long chain triglycerides (20 %w/v) (NIRPID 20%)

NIRMIX CENTRAL NIRMIX-PERI NIRMIX-PERI
Total Volume 2000 ml 1000 ml 2000 ml
NIRMIN 10 PLUS 800 ml 300 ml 600 ml
Glucose intravenous Infusion 30% 800 ml
Glucose intravenous Infusion 15% 530 ml 1060 ml
NIRPID 20% 400 ml 170 ml 340 ml

The contents of the three chambers have to be mixed before use, by opening of the peelable seals.
After mixing, NIRMIX bag will provide:

NIRMIX CENTRAL NIRMIX-PERI NIRMIX-PERI
Total Volume 2000 ml 1000 ml 2000 ml
Total Energy (Kcal) 2044 763 1560
Non protein Energy (Kcal) 1724 643 1285
Nitrogen (g) 12.8 4.8 9.6
Amino Acids (g) 80 30 60
Glucose (g) 240 80 159
Lipids (g) 80 34 68
Na+ (mmol) 36 13.5 27
K+(mmol) 20 7.5 15
Mg+2 (mmol) 2 0.75 1.5
Acetate-(mmol) 47.2 17.7 35.4
Cl-(mmol) 49.6 18.6 37.2
H2PO4- (mmol) 7.2 2.7 5.4
L-Malate-2 (mmol) 6 2.25 4.5
Osmolarity (mOsmol/L) 1158 818 833
pH 6.05 5.95 5 to 7

AVAILABILITY:

Domestic Yes Export Yes Domestic Product insert

DESCRIPTION :

NIRMIX-PERI is a triple chamber bag in a vacuum sealed transparent over wrap. Also placed between
the bag and over wrap are two ‘Ageless’ oxygen scavengers. The NIRMIX PERI bag is separated into three chambers by two peel seals.
Individual chambers consisting of Amino acid solution, Glucose solution and MCT-LCT based parenteral Fat emulsion respectively.

INDICATIONS :

Parenteral nutrition for adults where oral or enteral route for nutrition is not available, not possible, not sufficient or contraindicated.

  • Short bowel syndrome
  • Severe Acute Pancreatitis
  • Major Gastrointestinal Surgery
  • Multiorgan System failure
  • Major Trauma or Burn
  • Severe wasting in renal failure with dialysis
  • Small bowel transplantation

WARNING :

As with all parenteral solutions, additives (vitamins, electrolytes, trace elements, drugs) may be incompatible. In case of supplementation, compatibility should be checked before administration to the patient.
Additions should be performed under aseptic conditions after mixing the contents of the compartments.
Additions can be made through the injection port with a needle:
1. Prepare injection port
2. Puncture the port and inject
3. Mix the admixture and the additives
Administer the product only after breaking the seals and mixing the contents of the three compartments.
For single use only.
Do not connect in series in order to avoid air embolism due to possible residual air contained in the primary bag.

DOSAGE AND ADMINISTRATION :

The dose should be individualized and the choice of bag size should be made with regard to the patient’s clinical condition, body weight and nutritional requirements. To provide total parenteral nutrition, trace elements and vitamins should be given additionally. The nitrogen requirements for maintenance of body protein mass depend on the patient’s condition (e.g. nutritional state and degree of catabolic stress). The requirements are 0.10-0.15 g nitrogen/kg body weight/day in the normal nutritional state or in conditions with mild metabolic stress. In patients with moderate to high metabolic stress with or without malnutrition,
the requirements are in the range of 0.15-0.30 g nitrogen/kg body weight/day (1.0-2.0 g amino add/kg body weight/day). The corresponding commonly accepted requirements are 2.0-6.0 g for glucose and 1.0-2.0 g for fat.