Abstract

Background and Objectives: Parenteral nutrition (PN) provides nutrition intravenously, often as two-in-one (TIO) or all-in-one (AIO) solutions. These solutions are complex, containing around 50 chemical components, which can affect the admixture stability. While there is substantial data on stability tests for PN solutions, the methodologies and acceptance criteria are not well-defined in current literature. This scoping review aimed to identify and summarise the current tests and methods used to assess the stability of AIO solutions in hospital settings. Methods and Study Design: Comprehensive searches on stability tests and parenteral nutrition were conducted in Web of Science (WoS), PubMed, and Scopus on 11 January 2024, updated on 4 April 2025. Searches were limited to articles published in English from January 2010 to March 2025. Data extraction was done on the included studies for descriptive analysis. Results: 33 articles met the inclusion criteria, 25 focused on AIO solutions, six included both AIO and TIO, and one was on lipid emulsion only. Eleven stability tests were identified and classified into physical, chemical, and microbiological categories. The suggested core set of tests for assessing AIO solution stability includes visual inspection, pH measurement, particle size distribution using dynamic light scattering and light obstruction, zeta potential measurement, lipid peroxidation using the thiobarbituric acid reactive substances (TBARS) assay, and sterility testing via membrane filtration. Conclusions: This review identifies a suggested core set of stability tests essential for evaluating AIO solutions in hospital settings. Adoption of these standardised methods can enhance the reliability and consistency of stability assessments.

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