DSM-Firmenich director talks future of parenteral nutrition for hospitals and at-home

01 Jun 2023 --- The industry of parenteral nutrition, or intravenous feeding, focuses on providing nutrients to those unable to swallow or otherwise consume food. Modern advancements in the parenteral space are providing “hospital-ready” options to ensure proper nutrition for all.

NutritionInsight sits down with Kelsey Achenbach, global segment director for pharma and medical nutrition at DSM-Firmenich, and dives deeper into the future of parenteral nutrition, while examining the importance of various nutrients and how they can shape hospital care.

“To sustain life when regular food or enteral tube feeding is not an option, parenteral nutrition must meet all the nutritional requirements of the body, including fluid, carbohydrates, proteins, fats, vitamins and minerals.”

“While the fundamental components of parenteral nutrition are well established, developments in technology and science have advanced the field, focusing on premixes and customized solutions,” Achenbach adds.

Hospital care
Achenbach further details that hospital-ready solutions are a popular choice for parenteral nutrition. 

“The ready-made solution is easier to deliver in hospitals and reduces the risk of human error, contamination and infection risk. Key ingredients have been identified to support patients with specific medical conditions to create targeted solutions for parenteral nutrition,” Achenbach notes.

Kelsey Achenbach, global segment director for pharma and medical nutrition at DSM-Firmenich.Additionally, she stresses that the potential availability of home parenteral nutrition – used for patients when oral-enteral nutrition is temporarily or permanently impossible – is increasing globally. 

“The development of home parenteral nutrition has revolutionized clinical nutrition and made it possible to sustain patient care in the comfort of their own homes.”

Importance of nutrition
Getting the proper nutritional care to patients is about much more than just sustenance, Achenbach argues. 

“It’s about supporting optimal immune function, reducing medical complications and promoting recovery.”

She details that taking a condition-specific approach to parenteral nutrition enables manufacturers to develop targeted and appealing solutions that address the unique nutritional requirements of particular patient groups.

“Research suggests that tailoring nutrition to therapeutic treatment plans could help improve the effectiveness of nutritional management during patient care. With this in mind, healthcare companies can better support patients and clinical outcomes by expanding their portfolios to include enteral and parenteral nutrition solutions designed to be combined with drug therapies.”

Down to ingredients
Lipids are an essential ingredient that can be added to parenteral nutrition to serve as an energy source.

“Traditionally, soybean oil lipid emulsion has been the standard lipid for use in parenteral administration in the US. However, new-generation lipid emulsions, such as polyunsaturated fatty acid omega-3s, offer practitioners new opportunities to support parenteral patients – without leading to increased risk of liver disease.”

She explains that the omega 3 lipids are known to modify immune and inflammatory responses and have been confirmed by a meta-analysis showing significant clinical benefits of intravenous lipid infusions in hospitalized patients.

DSM-Firmenich offers the omega 3s eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) – derived from marine and microalgae sources – in customized solutions of various EPA/DHA ratios for potential use in parenteral nutrition.Omega 3 lipids are known to modify immune and inflammatory responses, says Achenbach. 

“EPA and DHA have significant roles in human health, from cardiovascular benefits to supporting brain injury and cancer patients. Established evidence indicates the potential of using EPA and DHA in treating chemotherapy-related complications, either alone or combined with conventional symptom management,” Achenbach details.

Other crucial ingredients to add to parenteral nutrition are essential vitamins for common conditions such as ischemic bowel disease, short bowel syndrome, cancer and inflammatory bowel disease.

“DSM-Firmenich has experience in the supply of vitamins and micronutrients, some of which are used in parenteral nutrition solutions. For example, ascorbic acid (vitamin C), vitamin A (as palmitate), vitamin D3 (cholecalciferol), thiamine (vitamin B1), riboflavin (vitamin B2) and many more,” she notes.

Conscious sourcing supports marine biodiversity
As the industry moves toward a more sustainable future, a recent study found that 95% of the largest pharmaceutical companies have set targets to improve their environmental footprint in alignment with international standards, and nutrition companies are following suit.

“Algal-derived lipids are a more sustainable alternative to traditional fish oil-based lipids,” says Achenbach. “As a result of commercial fishing – of which a third is driven by the fish oil industry – marine biodiversity has declined nearly 50% in the past 50 years.”

Switching from fish- to algal-oil omega-3s is an easy solution to help save our seas, she stresses.

“This 100% plant-based solution helps to protect our oceans and marine biodiversity. DSM-Firmenich offers next-generation lipid emulsions derived from algae, including the omega 3 fatty acids EPA and DHA,” she highlights.

“Parenteral nutrition is essential to provide lifesaving nutrients for those in their most critical states. Ongoing and future innovations will explore the benefits of customized solutions and sustainable ingredients for parenteral administration.”

By Beatrice Wihlander