Kabiven (Valine, Alanine, Arginine, Histidine, Isoleucine, Leucine, Methionine, Phenylalanine, Proline, Serin)

Kabiven is used in parenteral nutrition to meet protein and amino acid requirements when oral or enteral feeding is not feasible.

• Parenteral nutrition for patients unable to receive enteral feeding: provides a complete amino acid profile to sustain protein synthesis and nitrogen balance.
• Support of patients with increased protein requirements (e.g., trauma, surgery, critical illness): supplies essential substrates for tissue repair and metabolic demand.
• Nutritional supplementation in patients with malabsorption: delivers amino acids directly into the bloodstream to compensate for impaired gastrointestinal absorption.

• Kabiven delivers a balanced mixture of essential and non‑essential amino acids directly into the circulatory system. The supplied amino acids serve as substrates for protein synthesis, replenish nitrogen stores, and act as precursors for neurotransmitters, hormones and metabolic intermediates, thereby supporting anabolic processes and maintaining metabolic homeostasis during periods of catabolic stress. It also contributes to gluconeogenesis and helps regulate acid‑base balance.

Kabiven may be associated with infusion‑related and metabolic adverse reactions.

Common Side Effects

• Hyperglycemia: elevated blood glucose, particularly in diabetic patients.
• Electrolyte disturbances: alterations in potassium, sodium or calcium levels.
• Infusion site reactions: erythema, pain or phlebitis at the catheter insertion site.

Serious or Rare Side Effects

• Anaphylactic reaction: severe hypersensitivity that may be life‑threatening.
• Severe hyperosmolarity: high solute concentration causing neurologic symptoms.
• Hepatic dysfunction: marked elevation of liver enzymes indicating liver stress.

When using Kabiven, clinicians should observe several precautionary measures to ensure patient safety.

• Renal function: monitor serum creatinine and urea nitrogen levels regularly.
• Liver function: assess transaminases and bilirubin before and during therapy.
• Electrolyte balance: check serum potassium, sodium and calcium and adjust supplementation as needed.
• Glucose control: closely monitor blood glucose, especially in diabetic patients.
• Catheter care: maintain aseptic technique and inspect the infusion site for signs of infection or phlebitis.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Kabiven can interact with certain medications and solutions administered intravenously.

Major Interactions (Avoid)

• Concurrent high‑dose amino acid solutions: may cause hyperosmolarity and renal overload.
• Calcium‑containing IV solutions: can precipitate when mixed with Kabiven.
• Renal replacement therapy: alters clearance of amino acids, requiring dosage adjustment.

Moderate Interactions (Monitor Closely)

• Insulin therapy: amino acids may increase glucose load, necessitating insulin dose changes.
• Electrolyte supplements: risk of additive electrolyte shifts; monitor serum levels.
• Loop diuretics: may affect fluid and electrolyte balance during infusion.