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Total parenteral nutrition (TPN) requires the perfusion of more than 40 compounds (glucose, amino acids, lipids, electrolytes, vitamins and trace elements). Many systems of application are used. With the help of pharmacists, the current types of products and methods of TPN administration, as well as the evolution of TPN practice were evaluated in the Swiss hospitals during three consecutive years. Six different TPN systems are commonly used for adult patients. All lead to the administration of TPN in "all-in-one" admixtures. For adults, formula compounding is provided in large hospitals only. For pediatric TPN, formula compounding is routinely performed in the hospitals because individualized compositions are not available commercially. Regarding TPN-admixtures outpatients, they are mostly compounded in hospital pharmacies and delivered by 3 large hospitals. Compositions of TPN formula comply, on average, with European guidelines. An increased number of multidisciplinary nutritional support teams is still necessary to optimize the medical and economical management of TPN.
