Automation and standardization in parenteral nutrition compounding - Automated compounding systems and multi-chamber bags

Abstract

This review article, developed within the framework of the Spanish consensus on parenteral nutrition (PN) preparation, analyzes the role of two technological approaches that have significantly transformed clinical practice in this field: automated compounding systems (ACS) and multi-chamber bags. ACS enable full individualization of PN formulations, improve dosing accuracy, and reduce errors associated with manual handling through the integration of peristaltic or volumetric pumps managed by dedicated software. However, their implementation requires substantial initial investment, technical validation, ongoing staff training, and a robust system for quality oversight. In contrast, multi-chamber bags provide a standardized and safe alternative in clinical settings where nutritional requirements are predictable, such as conventional hospitalization or home parenteral nutrition. Their low level of manipulation results in reduced operational costs, shorter preparation times, and a lower risk of compounding errors. This document reviews optimal conditions for use, advantages, limitations, and selection criteria for both strategies. When correctly implemented, both approaches represent a significant advancement in the safety, efficiency, and quality of parenteral nutrition services. The choice between them should be individualized based on patient profile, available technical resources, and the organizational structure of each healthcare facility.