JP5828019B2 - Total nutritional fluid - Google Patents

Description

  The present invention relates to a comprehensive nutritional infusion solution that is formulated by combining a reducing sugar, an amino acid, an electrolyte, a vitamin, and trace elements and is heat-sterilized.

In recent years, parenteral nutrition therapy has made remarkable progress, and infusions containing sugars, electrolytes, and amino acids have been widely used. However, vitamins and trace element deficiencies occur only by administration of sugars, electrolytes, and amino acids when oral nutritional supplementation is not possible and only the parenteral nutrition solution is relied upon. In addition, if a large amount of sugar load is applied without administering vitamin B1, a large abnormality is caused in sugar metabolism, which may cause lactic acidosis, which is a serious side effect. Therefore, in medical practice, vitamin preparations and trace element preparations are added to sugar, electrolyte and amino acid infusion solutions at the time of use. However, mixed injection is complicated in operation, and there is a risk of medical error due to incorrect medication. In addition, the mixed injection operation may cause bacterial contamination and foreign matter, which may contribute to medical accidents. Therefore, a formulation containing a reducing sugar, an amino acid, an electrolyte and a vitamin and capable of mixing the solution under aseptic conditions has been developed.
For example, Patent Document 1 and Patent Document 2 disclose an infusion agent containing vitamins.
However, although the above-described conventional techniques improve the stability of vitamins, the inclusion of trace elements is an issue, and there is a need for improvement. For example, when the infusion is stored in a deoxygenated state so as not to be affected by oxygen, precipitation occurs when copper ions and iodine ions are stored in the same chamber. As a countermeasure, Patent Document 3 discloses an infusion agent containing copper ions and iodine ions separately and containing iodine ions in an amino acid solution and / or a sugar solution. In this method, since iodine ions are accommodated in a large-capacity chamber, there is a concern that the concentration of iodine, which is a trace amount, is further reduced, and the measurement of the content is hindered. Patent Document 4 discloses an infusion agent in which a chemical solution containing copper ions and iodine ions is stored together with an oxygen-containing gas in a gas barrier chamber. In this method, the oxygen barrier material is expensive, and since it is housed together with the oxygen-containing gas, the manufacturing process becomes complicated and there is a concern that the cost will increase.

Japanese Patent Laid-Open No. 11-158061 JP 2001-55328 A JP 2003-160501 A JP 2006-20657 A

  The present invention provides a comprehensive nutrition infusion solution containing reducing sugars, amino acids, electrolytes, vitamins and trace elements, wherein the vitamins and trace elements are stable for a long period of time. Reducing sugars, amino acids, electrolytes, vitamins, and trace elements have different stable pH ranges and may interact with each other, so it is necessary to set the composition in each chamber in consideration. In particular, when a trace element is blended, it is necessary to suppress a decrease in iodine content in an oxygen-free state during storage. At that time, it is necessary not to make it difficult to measure the iodine content for quality control.

As a result of intensive studies, the inventors have found a method for easily stabilizing trace elements while maintaining the stability of vitamins and eliminating the decrease in iodine content. Furthermore, the iodine content can be easily measured by this method. That is, by mixing copper with a trace element such as iron and iodine with a fat-soluble vitamin, the coexistence of copper ions and iodine ions is avoided. The present invention relates to the following comprehensive nutritional infusion.
1. Solution A, Solution B, Solution C, and Solution D are accommodated in each chamber of a four-chamber container separated by a partition wall that can communicate, Solution A contains reducing sugar and vitamin B1, and Solution B contains an amino acid. A comprehensive nutritional infusion, wherein the solution C contains at least one fat-soluble vitamin and iodine selected from vitamin A, vitamin D, vitamin E, and vitamin K, and the solution D contains copper.
2. Solution A, Solution B, Solution C, and Solution D are accommodated in each chamber of a four-chamber container separated by a partition wall that can communicate, Solution A contains reducing sugar and vitamin B1, and Solution B contains an amino acid. Solution C contains at least one fat-soluble vitamin and iodine selected from vitamin A, vitamin D, vitamin E, and vitamin K, Solution D contains iron and copper, and Solution A and / or Solution B And / or solution C and / or solution D containing an electrolyte and heat-sterilized.
3. 3. The comprehensive nutritional infusion solution according to 1 or 2, wherein the solution C further contains vitamin C and does not contain vitamin B2.
4). 3. The comprehensive nutritional infusion solution according to 1 or 2, wherein the solution C contains vitamin A, vitamin D, vitamin E, vitamin K, vitamin C, biotin, and folic acid, and does not contain vitamin B2.
5. The comprehensive nutritional infusion solution according to any one of 1 to 4, wherein the concentration of iodine in the solution C is from 0.10 mmol / L to 0.25 mmol / L.
6). The comprehensive nutritional infusion solution according to any one of 1 to 5, wherein the solution A further contains an electrolyte containing dipotassium phosphate as phosphorus and citric acid.
7). Solution A further contains vitamin B6, vitamin B12 and nicotinic acids, Solution B further contains vitamin B2 and pantothenic acids, Solution C further comprises vitamin C, vitamin H and folic acid. The comprehensive nutritional infusion preparation described in Crab.
8). Solution A further contains vitamin B6 and vitamin B12, solution B further contains vitamin B2, pantothenic acids and nicotinic acids, and solution C further contains vitamin C, vitamin H and folic acid. A comprehensive nutritional infusion preparation described in 1.
9. The comprehensive nutrition infusion solution according to any one of 1 to 8, wherein the solution D further contains manganese and zinc.
10. The comprehensive nutritional infusion solution according to any one of 1 to 9, wherein the electrolyte is at least one selected from sodium, potassium, magnesium, calcium, chloro, and phosphorus.
11. The comprehensive nutritional infusion solution according to any one of 1 to 10, wherein the vitamin B1 is at least one selected from thiamine, thiamine disulfide, fursultiamine, benfotiamine and salts thereof.
12 The pH of the solution A is 3 to 6, the pH of the solution B, the solution C and the solution D is 5 to 8, and the pH of the solution obtained by mixing the solution A, the solution B, the solution C and the solution D is 4.5 to 7. 5. The comprehensive nutritional infusion solution according to any one of 1 to 11, which is 5.
13. The comprehensive nutritional infusion solution according to any one of 1 to 12, wherein the amino acid concentration is 25 g / L to 55 g / L in the component composition when the solution A, the solution B, the solution C, and the solution D are mixed.
14 14. The comprehensive nutritional infusion solution according to 13, wherein the ratio of the non-protein calorie and the administered nitrogen amount is 90 to 160.

  In this method, since copper ions and iodine ions are blended in separate chambers, precipitation due to copper ions and iodine ions in a deoxygenated state can be prevented. Further, since iodine ions are accommodated in the chamber of the solution C having a small capacity, there is an advantage that the iodine concentration can be set high and the iodine content can be easily measured. In addition, since it is not necessary to store the chemical solution together with the oxygen-containing gas, it is not necessary to use a material having a high gas barrier property such as polyethylene / vinyl alcohol copolymer (EVOH) or polyvinylidene chloride (PVDC). This method can be manufactured at low cost. Since iodine ions and fat-soluble vitamins can be mixed stably, the content of fat-soluble vitamins and iodine does not decrease.

Hereinafter, the comprehensive nutrition infusion solution of the present invention will be described in detail.
The comprehensive nutritional infusion solution of the present invention housed in each chamber of a four-chamber container separated by a partition wall capable of communicating Solution A, Solution B, Solution C, and Solution D has stable components during heat sterilization and storage. While properly blended in each of the isolated chambers, the contents can be mixed in aseptic conditions after communication without essentially exposing the contents to the outside air.
Solution A in the comprehensive nutritional infusion preparation of the present invention has a basic composition of reducing sugar and vitamin B1, and preferably does not contain sulfite or a salt thereof. The sugar that can be used is not particularly limited as long as it is a sugar that is usually used for an infusion, and examples thereof include glucose, fructose, and maltose. Examples of vitamin B1 include thiamine, thiamine disulfide, fursultiamine, benfotiamine, and salts thereof, and thiamine hydrochloride is preferable. Preferably, the solution A further contains vitamin B6 and vitamin B12. Examples of vitamin B6 include pyridoxine, pyridoxal, pyridoxamine, and salts thereof, and pyridoxine hydrochloride is preferable. Vitamin B12 includes, for example, cyanocobalamin and its salts.
The pH of the solution A is preferably adjusted to 3-6.
The solution A preferably further contains an electrolyte. In this case, a phosphate salt such as dipotassium phosphate and a calcium salt may be contained as a phosphorus source. In this case, it is preferable to use citric acid as a pH adjuster from the viewpoint of improving the stability of the preparation during sterilization and long-term storage because calcium phosphate production is suppressed. It is particularly desirable to use citric acid when the reducing sugar and electrolyte concentration of the solution A is increased or when the pH is 5 or more.
The amount of the solution A is preferably 400 to 1400 ml, particularly preferably 400 to 1100 ml, as a preparation for half-day to daily administration.

Solution B is an amino acid solution. The mixing ratio of amino acids can be the same as the mixing ratio of conventional amino acid solutions. In the comprehensive nutrition infusion solution of the present invention, the amino acid that can be used is not particularly limited as long as it is an amino acid that is usually used for infusion. Specifically, L-isoleucine, L-leucine, L-lysine, L-methionine, L-phenylalanine, L-threonine, L-tryptophan, L-valine, L-alanine, L-arginine, L-aspartic acid, Examples include cysteine, L-glutamic acid, L-histidine, L-proline, L-serine, L-tyrosine, and glycine. The amino acid may be a salt as well as a free amino acid. Examples of such salts include L-lysine acetate and L-lysine hydrochloride. Further, some of them may be acyl forms or peptides. An example of such an acyl body is acetylcysteine.
To the solution B, sulfite or bisulfite, for example, sodium bisulfite can be added for stabilization of the amino acid solution.
The solution B preferably further contains vitamin B2 and pantetonic acids. Examples of vitamin B2 include riboflavin, riboflavin phosphate and its sodium salt, and flavin mononucleotide, and sodium riboflavin phosphate is particularly preferable. Examples of pantothenic acids include pantothenic acid or its calcium salt, panthenol, and the like, preferably panthenol.

The pH of the solution B is preferably adjusted to 5-8.
The amount of the solution B is preferably 200 to 700 ml, particularly preferably 300 to 600 ml, as a preparation for half-day to daily administration.

  It is preferable that nicotinic acids are blended in the A liquid or the B liquid. Examples of nicotinic acids include nicotinic acid, nicotinic acid amide, sodium nicotinic acid, and nicotinic acid methyl ester, and nicotinic acid amide is preferable.

Solution C contains at least one fat-soluble vitamin selected from vitamin A, vitamin D, vitamin E, and vitamin K, and a solubilizer can be added as necessary.
Vitamin A includes retinol and esters thereof, and more specifically, retinol palmitate, retinol acetate, and the like, with retinol palmitate being preferred. Examples of vitamin D include vitamin D2 (ergocalciferol), vitamin D3 (cholecalciferol) and active forms thereof, and cholecalciferol is preferable. Examples of vitamin E include tocopherol and its ester, more specifically tocopherol acetate and tocopherol succinate, and tocopherol acetate is preferred. Examples of vitamin K include vitamin K1 (phytonadione), vitamin K2 (menatetrenone), vitamin K3 (menadione), and phytonadione is preferred.
Examples of the solubilizer include polysorbate 80, polysorbate 20, HCO-60, and polyethylene glycol. In addition, sugar alcohols such as sorbitol, mannitol, xylitol, maltitol, or glycerin can be added as a stabilizer. By putting iodine into the solution C, iodine can be stably maintained. Furthermore, surprisingly, in solution C, the content of the fat-soluble vitamin does not decrease due to the presence of iodine. In addition, since the fat-soluble vitamin contained in the solution C requires a small volume medium to be mixed, the chamber of the solution C has a small volume, and the iodine concentration can be set high. This makes it possible to easily and accurately measure the iodine concentration, which is important from the viewpoint of maintaining the function of the thyroid gland. Preferably in solution C, the iodine concentration (iodide ion concentration) is 0.027 to 1.3 mmol / L, particularly preferably 0.10 to 0.25 mmol / L. Examples of the iodine supply source include potassium iodide and sodium iodide, and potassium iodide is preferable.
Solution C is substantially free of copper. For this reason, precipitation of iodine does not occur even in a deoxygenated state.
Solution C preferably further contains vitamin C and no vitamin B2. Examples of vitamin C include ascorbic acid and sodium ascorbate, and ascorbic acid is preferred. In the absence of vitamin B2, the fat-soluble vitamin, iodine and vitamin C mixture is particularly stable.
Solution C preferably further contains vitamin H (biotin) and folic acid. In particular, when solution C contains vitamin A, vitamin D, vitamin E, vitamin K, vitamin C, vitamin H (biotin), and folic acid, and does not contain vitamin B2, the stability of these components in solution C Is particularly high.
The pH of the solution C is preferably adjusted to 5-8.
The amount of the solution C is preferably 1 to 10 ml, particularly preferably 2 to 8 ml, as a preparation for half-day to daily administration.

The solution D contains copper, and preferably contains iron and copper trace elements. It is preferable to contain trace elements such as manganese and zinc in addition to iron and copper.
Examples of the iron supply source include iron sulfate, ferrous chloride, ferric chloride, and iron gluconate. Examples of the copper supply source include copper sulfate. Examples of the manganese supply source include manganese chloride and manganese sulfate. Examples of the zinc supply source include zinc sulfate, zinc chloride, zinc gluconate, zinc lactate, and zinc acetate.
Moreover, chondroitin sodium sulfate can be added to the solution D as needed.

The pH of the solution D is preferably adjusted to 5-8.
The amount of the solution D is preferably 1 to 10 ml, particularly preferably 2 to 8 ml, as a preparation for half-day to daily administration.
The comprehensive nutrition infusion solution of the present invention contains an electrolyte. The electrolyte is not particularly limited as long as it is used for normal electrolyte infusions, and examples thereof include sodium, potassium, calcium, magnesium, phosphorus, chlorine, and the like, and inorganic salts and organic salts that generate ions in an aqueous solution Is preferred. The electrolyte may be contained in any of the solutions A to D, but is preferably contained in the solution A. The electrolyte is necessary for maintaining the function of the living body and the electrolyte balance of the body fluid.

The pH adjuster used in each solution is not particularly limited as long as it is physiologically acceptable, and for example, organic acids, inorganic acids, organic bases, and inorganic bases can be used. Examples of the organic acid include acetic acid, citric acid, lactic acid, succinic acid, and malic acid. Examples of the inorganic acid include hydrochloric acid, sulfuric acid, and phosphoric acid. On the other hand, examples of the organic base include sodium acetate, sodium citrate, and sodium lactate, and examples of the inorganic base include alkali metal hydroxide (for example, sodium hydroxide).
Intravenous fluid for central vein has a total water content of 1400 to 1800 mL as a daily dose, amino acids of 45 to 75 g, and a ratio (NPC / N ratio) of non-protein calorie and dose of nitrogen of 90 to 160 The total nutritional infusion solution of the present invention preferably has a reducing sugar and amino acid concentration suitable for providing such an infusion solution. The comprehensive infusion preparation of the present invention can be used for patients at the time of invasion after surgery of the digestive system or circulatory system, and ingestion or inadequate oral or tube nutrition such as dysphagia or sequelae of cerebral infarction Therefore, it can also be used for patients whose energy requirements are low, such as elderly people.
Moreover, it is preferable that the vitamins contained in the comprehensive infusion preparation of the present invention have a vitamin concentration that can ensure the required amount of vitamin recommended by the American Medical Association. For example, vitamin B1 (thiamine) 6.0 mg / day, vitamin C 200 mg / day.
In the comprehensive nutritional infusion solution of the present invention, the following is preferable in the component composition of the solution obtained by mixing the solution A, the solution B, the solution C and the solution D:
Glucose is 50 to 400 g / L, more preferably 100 to 250 g / L.

The total amount of amino acids is 25.0 to 55.0 g / L.
(Each amino acid (converted as a free form))
L-isoleucine is 0.2-14.0 g / L, more preferably 1.0-6.0 g / L,
0.4 to 20.0 g / L of L-leucine, more preferably 1.0 to 10.0 g / L,
L-lysine is 0.2-14.0 g / L, more preferably 1.0-5.0 g / L,
L-methionine is 0.1 to 8.0 g / L, more preferably 0.5 to 5.0 g / L,
L-phenylalanine is 0.2 to 12.0 g / L, more preferably 1.0 to 5.0 g / L,
L-threonine is 0.1 to 8.0 g / L, more preferably 0.5 to 4.0 g / L,
L-tryptophan in an amount of 0.04 to 3.0 g / L, more preferably 0.2 to 15 g / L,
L-valine is 0.1 to 16.0 g / L, more preferably 1.0 to 6.0 g / L,
L-alanine is 0.2-14.0 g / L, more preferably 1.0-6.0 g / L,
L-arginine is 0.2 to 14.0 g / L, more preferably 1.0 to 7.0 g / L,
L-aspartic acid is 0.01-4.0 g / L, more preferably 0.1-2.0 g / L,
L-glutamic acid is 0.01-6.0 g / L, more preferably 0.1-2.0 g / L,
L-histidine is 0.1 to 8.0 g / L, more preferably 0.5 to 5.0 g / L,
L-proline is 0.1 to 10.0 g / L, more preferably 0.5 to 5.0 g / L,
L-serine is 0.1 to 6.0 g / L, more preferably 0.2 to 3.0 g / L,
L-tyrosine is 0.01 to 2.0 g / L, more preferably 0.05 to 1.0 g / L,
0.1 to 12.0 g / L of glycine, more preferably 1.0 to 5.0 g / L,
L-cysteine is 0.01 to 2.0 g / L, more preferably 0.1 to 2.0 g / L.

(Vitamins)
Vitamin A 500-5000 IU / L, more preferably 1000-4000 IU / L,
Vitamin D (as cholecalciferol) 1.0-20 μg / L, more preferably 1.0-10 μg / L,
Vitamin E (as tocopherol acetate) 1.0 to 30 mg / L, more preferably 2.0 to 15 mg / L,
Vitamin K (as phytonadione) 0.1-5.0 mg / L, more preferably 0.2-2.5 mg / L,
Vitamin B1 (as thiamine hydrochloride) 0.5-50 mg / L, more preferably 1.0-20 mg / L,
Vitamin B2 (as riboflavin) 0.5-10 mg / L, more preferably 1.0-5.0 mg / L,
Vitamin B6 (as pyridoxine hydrochloride) 0.5-10 mg / L, more preferably 1.0-5.0 mg / L,
1.0-20 μg / L of vitamin B12 (as cyanocobalamin), more preferably 1.0-10 μg / L,
Nicotinic acid (as nicotinic acid amide) is 5.0 to 80 mg / L, more preferably 10 to 50 mg / L,
Vitamin C (as ascorbic acid) is 25 to 300 mg / L, more preferably 25 to 200 mg / L,
1.0 to 30 mg / L of pantothenic acid (as panthenol), more preferably 1.0 to 20 mg / L,
50 to 500 μg / L of folic acid, more preferably 100 to 400 μg / L,
Vitamin H (biotin) is 10 to 200 μg / L, more preferably 10 to 100 μg / L.

(Trace element)
5-100 μmol / L of iron,
1-20 μmol / L of copper,
0.1-5 μmol / L of manganese,
5 to 150 μmol / L of zinc,
Iodine 0.1-5 μmol / L.

(Electrolytes)
25-75 mEq / L of sodium ion,
15-45 mEq / L of potassium ion,
Calcium ion 2.5 to 10 mEq / L,
2.5-10 mEq / L of magnesium ion,
2.5-75 mEq / L of chloride ion,
Phosphorus 0-20 mmol / L.

  Moreover, in the comprehensive nutrition infusion solution of the present invention, the pH of the solution obtained by mixing the solution A, the solution B, the solution C, and the solution D is preferably 4.5 to 7.5.

  A well-known container can be used as a four-chamber container separated by a partition wall that can communicate. Of these, an infusion bag in which the partition wall is constituted by an easily peelable seal is preferable because the communication work is simple. Suitable materials for the infusion bag are, for example, polyolefins such as polyethylene, polypropylene and polybutene, ethylene / propylene copolymers, crosslinked ethylene / vinyl acetate copolymers, and laminates thereof.

  The container material of the solution C is desirably a material that suppresses the adsorption of fat-soluble vitamins, and examples thereof include cyclic polyolefin, polyethylene terephthalate, polyacrylonitrile, and the like. Further, it is desirable that the surface area of the container is small. In addition, as a laminated body, the innermost layer which contact | connects the solution C can also be made from these materials.

  In addition, from the viewpoint of preventing a decrease in content due to a reaction between a trace element of the solution D and a gas generated from the sulfur-containing amino acid of the solution B, a material that is hardly permeable to gas is desirable as a container material of the solution D. Examples thereof include cyclic polyolefin, polyethylene terephthalate, polyacrylonitrile and the like. In addition, if the solution C and the solution D are the same material, there exists an advantage which can simplify a manufacturing process.

It is desirable to enclose the container filled with the chemical solution in an outer packaging material made of a gas non-permeable film having a light shielding property together with an oxygen scavenger by a conventional method. Examples of the gas non-permeable outer packaging material having light shielding properties include aluminum foil and aluminum vapor deposition film which are generally used. In addition, it is possible to combine a light-shielding layer and a gas non-permeable layer, and the light-shielding layer is not particularly limited as long as it can clear the transmittance allowed as the light shielding performance. For example, a general-purpose resin film subjected to black printing can be used. Further, as the gas non-permeable outer packaging material, polyethylene terephthalate, polyethylene naphthalate, ethylene / vinyl alcohol copolymer, polyvinylidene chloride, polyacrylonitrile, polyamide, alumina vapor deposition film, silica vapor deposition film, etc. can be selected. It is possible to use one kind or a combination of several kinds.
As the oxygen scavenger, those containing iron compounds such as iron hydroxide, iron oxide and iron carbide as main components are used. Commercially available products include AGELESS (Mitsubishi Gas Chemical Co., Ltd.), Modulan (Nippon Kayaku Co., Ltd.), Secur (Nippon Soda Co., Ltd.) and the like.
The space between the infusion bag and the outer packaging container is preferably filled with an inert gas such as nitrogen.
Thus, the inside of the outer packaging material including each liquid can be deoxygenated during the storage period.

  EXAMPLES Next, although an Example is given and this invention is demonstrated further in detail, this invention is not limited to these.

Example 1
After dissolving glucose and electrolyte in water for injection, vitamin B1 (thiamine hydrochloride), vitamin B6 (pyridoxine hydrochloride), nicotinamide, vitamin B12 (cyanocobalamin) and the like were dissolved. After adjusting the pH to 4.5 using acetic acid, the total volume was adjusted to 500 mL, followed by filtration using a membrane filter (0.2 μm) to prepare Solution A having the composition shown in Table 1.

  After dissolving each amino acid in water for injection, vitamin B2 (phosphoflavin sodium phosphate) and panthenol were dissolved. Sodium bisulfite was dissolved in this solution as a stabilizer. After adjusting the pH to 6.5 using acetic acid, the total volume was adjusted to 300 mL, and filtration was performed using a membrane filter (0.2 μm) to prepare Solution B having the composition shown in Table 1.

  Vitamin A (retinol palmitate), vitamin D3 (cholecalciferol), vitamin E (tocopherol acetate) and vitamin K1 (phytonadione) were solubilized with polysorbate 20 and polysorbate 80, and then dissolved in water for injection. Furthermore, potassium iodide, sorbitol, vitamin C (ascorbic acid), vitamin H (biotin) and folic acid were dissolved. After adjusting the pH to 6.0 using sodium hydroxide, the total volume was adjusted to 3 mL, followed by filtration using a membrane filter (0.2 μm) to prepare Solution C having the composition shown in Table 1.

  An iron colloid solution was prepared by alternately adding an aqueous solution in which ferric chloride was dissolved in water for injection and an aqueous solution in which sodium hydroxide was dissolved in water for injection into an aqueous solution in which sodium chondroitin sulfate was dissolved in water for injection. Manganese chloride, zinc sulfate, and copper sulfate were dissolved in this solution. After adjusting the pH to 5.7 using sodium hydroxide, the total volume was adjusted to 3 mL, followed by filtration using a membrane filter (0.2 μm) to prepare a solution D having the composition shown in Table 1.

500 mL, 300 mL, 3 mL, and 3 mL were filled in each chamber of a four-chamber container separated by a partition wall capable of communicating Solution A, Solution B, Solution C, and Solution D, and the space was sealed after nitrogen replacement. After autoclaving according to a conventional method, the preparation is enclosed in an outer packaging material made of a gas-impermeable film together with an oxygen scavenger (ageless, manufactured by Mitsubishi Gas Chemical Co., Ltd.). Obtained. The pH of Solution A, Solution B, Solution C, and Solution D were about 4.5, 6.5, 6.0, and 5.6, respectively.
In addition, pH of the composition which mixed solution AD was 5.4.

(Example 2)
In the same manner as in Example 1, solutions A, B, C and D having the compositions shown in Table 1 are prepared. 600 mL, 300 mL, 3 mL, and 3 mL were filled in each chamber of a four-chamber container separated by a partition wall capable of communicating Solution A, Solution B, Solution C, and Solution D, and the space portion was sealed with nitrogen and sealed. After autoclaving according to a conventional method, the preparation is enclosed in an outer packaging material made of a gas-impermeable film together with an oxygen scavenger (ageless, manufactured by Mitsubishi Gas Chemical Co., Ltd.). Obtained. The pH of Solution A, Solution B, Solution C, and Solution D were about 4.5, 6.5, 6.0, and 5.6, respectively.

(Example 3)
In the same manner as in Example 1, solutions A, B, C and D having the compositions shown in Table 1 were prepared. However, citric acid was used as the pH adjuster of Solution A. 500 mL, 300 mL, 3 mL, and 3 mL were filled in each chamber of a four-chamber container separated by a partition wall capable of communicating Solution A, Solution B, Solution C, and Solution D, and the space was sealed after nitrogen replacement. After autoclaving according to a conventional method, the preparation is enclosed in an outer packaging material made of a gas-impermeable film together with an oxygen scavenger (ageless, manufactured by Mitsubishi Gas Chemical Co., Ltd.). Obtained. The pH of Solution A, Solution B, Solution C, and Solution D were about 4.5, 6.5, 6.0, and 5.6, respectively. In addition, pH of the composition which mixed solution AD was 5.4.

(Comparative Example 1)
In the same manner as in Example 1, solutions A, B, C and D having the compositions shown in Table 1 were prepared. 500 mL, 300 mL, 3 mL, and 3 mL were filled in each chamber of a four-chamber container separated by a partition wall capable of communicating Solution A, Solution B, Solution C, and Solution D, and the space was sealed after nitrogen replacement. After autoclaving according to a conventional method, the preparation is enclosed in an outer packaging material made of a gas-impermeable film together with an oxygen scavenger (ageless, manufactured by Mitsubishi Gas Chemical Co., Ltd.). Got. The pH of Solution A, Solution B, Solution C, and Solution D were about 4.5, 6.5, 6.0, and 5.6, respectively.

(Test Example 1)
The content of trace elements after the comprehensive nutritional infusion prepared in Example 1 and Comparative Example 1 was stored at 40 ° C. and 75% RH for 1 month was measured. The results are shown in Table 2. The content is expressed as a percentage of the composition.

  From the results shown in Table 2, it was revealed that Example 1 had a small decrease in the content of trace elements and was stable for a long time even after storage at 40 ° C. and 75% RH for 1 month as compared with Comparative Example 1.

  In addition, the content of vitamins after the comprehensive nutritional infusion prepared in Example 1 and Comparative Example 1 was stored at 40 ° C. and 75% RH for 1 month was measured. The results are shown in Table 3. The content is expressed as a percentage of the composition.

  From the results in Table 3, it is clear that Example 1 shows little decrease in vitamin content even after storage at 40 ° C. and 75% RH for one month, and that the comprehensive nutrition infusion solution of the present invention is stable in vitamins for a long period of time. It became. From the comparison between Example 1 and Comparative Example 1, the vitamins (A, D3, E, K1, C, folic acid, biotin) contained in the solution C are not included even if the solution C contains iodine. It was found to be as stable as the case. (The compositions of the solutions A and B are the same in Example 1 and Comparative Example 1, and there is no difference between the two in terms of the stability of vitamins contained therein.)

(Test Example 2)
The content of vitamins after the comprehensive nutritional infusion prepared in Example 3 was stored at 40 ° C. and 75% RH for 1 month was measured. The results are shown in Table 4. The content is expressed as a percentage of the composition. Example 3 is different from Example 1 in that nicotinic acid amide is contained in the B solution instead of the A solution. However, in Example 3, as in Example 1, it is contained in the solutions A, B, and C. The vitamins that were made were stable for a long time.

  The concentration of iodine in the solution C in Examples 1 to 3 can be easily measured without using a chemical solution by using, for example, an HPLC method using a UV detector.

  INDUSTRIAL APPLICABILITY The present invention can provide a comprehensive nutritional infusion that contains reducing sugars, amino acids, electrolytes, vitamins, and trace elements, and vitamins and trace elements are stable for a long period of time.

Claims (13)

  Solution A, Solution B, Solution C, and Solution D are accommodated in each chamber of a four-chamber container separated by a partition wall that can communicate, Solution A contains reducing sugar and vitamin B1, and Solution B contains an amino acid. A comprehensive nutritional infusion, wherein solution C contains vitamin E and iodine, which are fat-soluble vitamins, and solution D contains copper.   Solution A, Solution B, Solution C, and Solution D are accommodated in each chamber of a four-chamber container separated by a partition wall that can communicate, Solution A contains reducing sugar and vitamin B1, and Solution B contains an amino acid. Solution C contains vitamin E, which is a fat-soluble vitamin, and iodine, solution D contains iron and copper, and solution A and / or solution B and / or solution C and / or solution D contains an electrolyte. A comprehensive nutritional infusion solution characterized by being heat-sterilized.   The comprehensive nutrition infusion solution according to claim 1 or 2, wherein the concentration of iodine in the solution C is from 0.10 mmol / L to 0.25 mmol / L.   The comprehensive nutrition infusion solution according to any one of claims 1 to 3, wherein an iodine supply source in the solution C is sodium iodide or potassium iodide. The comprehensive nutrition infusion solution according to any one of claims 1 to 4, wherein the solution A further contains citric acid.   The comprehensive nutritional infusion solution according to any one of claims 1 to 5, wherein the solution C further contains at least one fat-soluble vitamin selected from vitamin A, vitamin D, and vitamin K.   The solution A further contains vitamin B6 and vitamin B12, the solution B further contains vitamin B2 and pantothenic acids or nicotinic acids, and the solution C further contains vitamin H and folic acid. The comprehensive nutritional infusion preparation described in the item.   The comprehensive nutrition infusion solution according to any one of claims 1 to 7, wherein the solution D further contains manganese and zinc.   The comprehensive nutrition infusion according to any one of claims 1 to 8, wherein the electrolyte is at least one selected from sodium, potassium, magnesium, calcium, chloro, and phosphorus.   The comprehensive nutritional infusion according to any one of claims 1 to 9, wherein the vitamin B1 is at least one selected from thiamine, thiamine disulfide, fursultiamine, benfotiamine and salts thereof.   The pH of the solution A is 3 to 6, the pH of the solution B, the solution C and the solution D is 5 to 8, and the pH of the solution obtained by mixing the solution A, the solution B, the solution C and the solution D is 4.5 to 7. The integrated nutritional infusion solution according to any one of claims 1 to 10, which is 5.   The comprehensive nutritional infusion solution according to any one of claims 1 to 11, wherein an amino acid concentration is 25 g / L to 55 g / L in a component composition when the solution A, the solution B, the solution C, and the solution D are mixed.   The comprehensive nutrition infusion according to claim 12, wherein the ratio of the non-protein calorie and the dose of nitrogen is 90 to 160.