BFLUID
(aminoacid,electrolytes,glucose,VITAMI
NB1) INDICATION: Mild
Hypoproteinemia (low level of protein in
the blood) , Mild-Moderate Malnutrition
(refers to deficiencies, excesses, or
imbalances in a person's intake of energy
and/or nutrient)
PRICE: 500ml P927 , 1000ml P1535
ADMINISTERED : Peripheral Vein
(kamay)
INFUSION RATE: 500 ml 2-3hrs
(standard) extend infusion rate 4-6hrs
depending on patient medical condition ,
1000ml (4-6hrs) extended (6,8,12hrs)
ENERGY CALORIES: 500 ml - 210
kCal , 1000ml - 420 kCal
PROTEIN AMINO ACID: 500ml - 15g ,
1000ml - 30g (3% amino acid)
GLUCOSE CARBOHYDRATES:
500ml- 37.5 (7.5%) , 1000ml-75 (7.5%)
DIFFERENCE OF BFLUID: Vitamin B1
Thiamine - burning of glucose without
thiamine it can cause lactic acidosis
( medical condition characterized by the
buildup of lactate) to patients.
MAINTENANCE SOLUTIONS: Some
maintenance solution only have glucose
content, if the body already use glucose
for energy, but how about for muscle
repair. For this we need amino acid for
muscle repair to promote protein
synthesis. Its better to have glucose + at
the same time we have amino acid for
muscle repair. after surgery POST OP -
we need muscle repair for wound healing
its important to have protein content.
Good morning Doctor, My name is
Tristine ako po ang pumalit kay
Narizz. Nagagamit niyo po ba si
Fluid? (Doctor, Saan patient niyo po
nagagamit? thank you so much po
doctor na nagagamit niyo po si Bfluid
kahit wala napo yung previous MR)
Anyway from now on po ako napo
ang magcocover po sainyo and
tutuloy kopo ang mga nasimulan niya
po. Pwede pong thru online po,face to
face kasi po this yr hybrid napo kami
meaning pwede po kami pumunta
sainyonwith safety protocols and
depende din po sainyo doctor kung
papayag po kayo for f2f discussion
somewhere near the hospital or san po
kayo comfortable okay lang po ba
yun sainyo or sa online naman po
pwede din po. Starting today ako
napo magbibigay sainyo ng update
regarding our product na BFLUID. Sa
post op ganitong case , ilang bfluid po
BFLUID 15g protein, 210kCal 500mg
420kCal 1 Liter which is enough for
your short term NPO patient.
PRE-operative day (bago operahan)
IN-operable (during surgery
POSTOP (POD) postoperative day
POM posteoperative month
SUPPLEMENTAL PARENTERAL
NUTRITION 1st slide
Good day Doctor, Please allow me
po to share with you BLFUID as
Supplemental Parenteral Nutrition for
your patients. The nutrition algorithm,
prinapriority po nito ang enteral or
oral feeding as mainstream nutrition
route for patients. However,
numerous problem may occur during
oral or enteral feeding. One example
po is ang dilemma of protein during
enteral feeding. Allow me to share
with you the article from Velsman
regarding enteral nutrition in ICU is
insufficient to achieve adequate
protein delivery.
71 patients in ICU were given
nutrition in 3 different routes
57 enteral route 10 combination of
EN and PN 4 PN alone.
RESULT: the study showed 62% of
the 71 patients achieved the energy
target, 49% achieved the protein
target range. 27% were energy
underfed, and 51% were protein
underfed.
IN ORDER FOR YOUR PATIENTS
TO ACHIEVE THEIR PROTEIN
REQUIReMENT, YOU MAY
SUPPLEMENT WITH PN WITH
HIGH AMOUNT OF PROTEIN.
WHICH BFLUID HAS THEIR
CHARACTERISTICS DOCTOR.
ADMINISTERING OF AMINO HYPOPROTEINEMIA - is a
ACIDS IS EFFECTIVE IN
CONTENT OF BFLUID condition in which a
INCREASING ALBUMIN AND person has very low
MAINTAINING NITROGEN Again doctor, this are the
levels of protein in the
BALANCE content of BFLUID for 500ml
blood.
the patient can get 210 kCal
also for 1000ml patient can Doctor, I wanna share
As shown on this article last 2016
BFLUID was used for peripheal
get 420 kCal. BFluid also with you that you can use
vein infusion to patients with contains hight amount of BFLUID for patients
ESOPHAGEAL (ESOPAGIAL ) Protein (Amino Acid) 15g in suffering with
CANCER after esophagectomy 500ml and 30g in 1L that can hypoproteinemia.
compensate the protein
On the left side table, makikita po INDICATION FOR
needed together with EN PARENTERAL NUTRITION
naten that the study showed
significant improvement on (enteral) of oral feeding.
albumin level with BFLUID as SPN First of all, allow me to
(supplemental parenteral I also want to highlight doctor introduce the position of
that BFLUID is 2 chamber bag BFLUID injection as PPN.
nutrition) as early as 14 POD
(postoperativeday) and was Pinaghiwalay si amino acid BFLUID doctor is a partial
maintained up to 1 POM and glucose to prevent peripheral parenteral nutrition
(postoperative month) maillard reaction can be given for patients who
(discoloration) may be deprived of oral intake
You need a proper balance of albumin to keep
fluid from leaking out of blood vessels. Albumin for less than <2 weeks.
gives your body the proteins it needs to keep BFLUID contains amino
growing and repairing tissue. Also on the lower chamber acid,electrolytes,glucose and
doctor, BFLUID has a lower VITAMIN B1 that should be
Also doctor on the right table, the
nitrogen level was also amount of potassium. Because given by peripheral vein to
high amount of potassium patients with MILD
maintained up to 7POD with
HYPOPROTEINEMIA,MILD-
BFLUID as SPN. given to patients can cause MODERATE MALNUTRITION
HYPERKALEMIA and due to inadequate oral intake
Nitrogen is an important part of our bodies.
Amino acids all contain nitrogen and these are sometimes lead to renal and before and after surgery.
the building blocks that make up the proteins in
your hair, muscles, skin and other important failure.
tissues. ... We cannot survive without nitrogen
in our diet – we get it in the form of protein.

WITH BFLUID, your patients can

get the caloric intake they need.
TO MAINTAIN NUTRITION
STATUS OF THE PATIENT
For this slide doctor, the main
objective is giving PPN to maintain
the nutrition status of your patient.
For the first scenario, you can give
BFLUID for patient who can have oral
intake or tube feeding but the
required caloric intake cannot be
given to the patient. Nakakapag oral
intake naman po si patient pero hindi
nabibigay ng oral intake niya yung
required amount need ng katawan ni
patient. With this doctor you can
supplement with BFLUID as SPN
2nd scenario naman po doctor is yung
mga pre operative, some patients
pinagdidiet po before operahan and
yung early post operative period after
operahan hindi naman po agad
magana kumain si patient BFLUID can
maintain the nutrition status of the
patient.
3rd you can also give BFLUID for
patient with mild to moderate
malnutrition due to disease condition
together with oral or enteral feeding.
HOWEVER, BFLUID is not suitable to
patient with severe malnutrition
requiring massive amount of
nutrients. ( TPN total parenteral
nutrition)
SIGNIFICANCE OF
CARBOHYDRAT/AMINO ACID CONTENT OF
SUPPLMENTATION
BFLUID
In this slide doctor,allow me to share
with you a study by Gamble who Again doctor, this are the
investigated the body proteins-sparing
content of BFLUID for 500ml
effect of glucose administration during
starvation. the patient can get 210 kCal
also for 1000ml patient can
During starvation, approximately 70g/ or
approximately 400g for 6days of protein
get 420 kCal. BFluid also
was lost due to the catabolism of the contains hight amount of
body proteins. This is equivalent to Protein (Amino Acid) 15g in
approximately 2kg of muscle. After
glucose administration, the protein 500ml and 30g in 1L that can
catabolism was inhibited. compensate the protein
needed together with EN
In glucose dose of 100g/day,glucose
administation inhibited protein loss to (enteral) of oral feeding.
approximately 50%
When glucose was administered at 200g, I also want to highlight
the degree of protein catabolism was
similar to the 100g. doctor that BFLUID is 2
chamber bag
This indicated that administration of
Pinaghiwalay si amino acid
glucose and energy source alone, cannot
and glucose to prevent
fully inhibit the catabolism of body
protein. maillard reaction
According to this article, even we doble
(discoloration)
the dose of glucose, kulang pa din po
yung protein. Also on the lower chamber
doctor, BFLUID has a lower
FOR HIGHLY STRESS PATIENTS, such as
surgery the body demands energy and amount of potassium.
needed additional protein with that the Because high amount of
patient needs energy and protein (amino
acid administration) for the improvement
potassium given to patients
of nitrogen balance and protein can cause HYPERKALEMIA
metabolism which is very important sa and sometimes lead to renal
body.
failure.
In order to to fill the gap in preventing
protein loss, BFLUID INJECTION already
include 30 grams of amino acid, 420 kCal
and Vitamin B1.
IMPORTANCE OF PROTEIN
Doctor, please allow me to share
with you the importance of
protein?
Protein is a macronutrient that is essential to
building muscle mass.
Every cell in the human body contains protein.
The basic structure of protein is a chain of
amino acids. You need protein in your diet to
help your body repair cells and make new
ones. Protein is also important for growth and
development in children, teens, and pregnant
women.
GUIDELINE
RECOMMENDATION
A recommendation from ASPEN,
initiate PARENTERAL NUTRITION
as soon as possible when EN
Enteral nutrition is not
suitable/feasible
A recommendation also from
ESPEN on normal nutrition within
3 days should receive PN within
24-48 hrs if EN is contraindicated
of they cannot tolerate EN.
For SPN According to ASPEN
(Supplemental Parenteral
Nutrition) SPN cosidered after 7-
10 days if unable to meet within
60% of energy requirment.
From ESPEN, receiving less than
rheur targeted enteral nutrition
after 2 days.
For PN and SPN, Bfluid can be
given to your patients.
ROLES OF AMINO ACID AND
AMOUNTS OF INEVITABLE (certain
to happen, unavoidable) NITROGEN
LOSS
In giving amino acid doctor, we also have
to make sure that our patient will utilize
it properly. This is the reason why BFLUID
is combined with glucose.
If we combine AMINO ACID with
GLUCOSE giving your patient a sufficient
amount of calories , the amino acid will
be utilize properly for protein synthesis
which will result for the improvement of
nitrogen balance and improvement in
protein synthesis.
If the nitrogen balance and protein
metabolism is improve we can prevent
postoperative complication. We all know
that amino acids have a role in
building and repairing body tissues,
which is critical to wound healing.
Kapag wala pong complication it will
have improvement in treatment
results.
AMOUNT OF INEVITABLE
NITROGEN LOSS (FAO/WHO)
As you can see doctor for normal
individual like us we loss 26.3 g/day
of nitrogen and this is unavoiable
because kapag umihi,nagpoop or
sweat nagloloss na tayo ng nitrogen
sa katawan what more yung may mga
sakit pa doctor they need protein to
maintain nitrogen balance.
ARTICLE IN PRESS
Allow me to share with you the article from
Velsman regarding enteral nutrition in ICU is
insufficient to achieve adequate protein delivery.
71 patients in ICU were given nutrition in 3
different routes
57 enteral route 10 combination of EN and PN 4 PN
alone.
RESULT: the study showed 62% of the 71 patients
achieved the energy target, 49% achieved the
protein target range. 27% were energy underfed, and
51% were protein underfed.
IN ORDER FOR YOUR PATIENTS TO
ACHIEVE THEIR PROTEIN REQUIReMENT,
YOU MAY SUPPLEMENT WITH PN WITH
HIGH AMOUNT OF PROTEIN. WHICH BFLUID
HAS THEIR CHARACTERISTICS DOCTOR.
CONTENT OF BFLUID
Again doctor, this are the content of
BFLUID for 500ml the patient can get 210
kCal also for 1000ml patient can get 420
kCal. BFluid also contains hight amount
of Protein (Amino Acid) 15g in 500ml and
30g in 1L that can compensate the
protein needed together with EN
(enteral) of oral feeding.
I also want to highlight doctor that
BFLUID is 2 chamber bag
Pinaghiwalay si amino acid and glucose
to prevent maillard reaction
(discoloration)
Also on the lower chamber doctor,
BFLUID has a lower amount of
potassium. Because high amount of
potassium given to patients can cause
HYPERKALEMIA and sometimes lead to
renal failure.
Good day Doctor, please allow me
to share with your malnutrition.
MALNUTRITION - refers to
deficiencies, excesses, or imbalances
in a person's intake of energy and/or
nutrients
DECISION TREE
Doctor, just a reminder of the
decision tree of nutrition.
If the gut or GI is functioning, the
priority is to use it by providing
enteral nutrition. However, if the
patients has inadequate oral
intake it is recommended that you
supplement with a low calorie
Parenteral nutrition SUCH AS
BFLUID.
Nakakain si pasyente pero paonti
onti hindi niya nakukuha yung
right amount of nutrients we
recommend BFLUID for SPN.
For PN and SPN, Bfluid can be
Also, if you expect your patient to
given to your patients.
take oral food in a few days of
hospitalization and to prevent
malnutrition. You can also give
BFLUID as PPN. Example of this
yung mga patient na nakakaopera
lang po wala silang ganang kumain
you can give BFLUID.
GUIDELINE
RECOMMENDATION
A recommendation from ASPEN,
initiate PARENTERAL NUTRITION
as soon as possible when EN
Enteral nutrition is not
suitable/feasible
A recommendation also from
ESPEN on normal nutrition within
3 days should receive PN within
24-48 hrs if EN is contraindicated
of they cannot tolerate EN.
For SPN According to ASPEN
(Supplemental Parenteral
Nutrition) SPN cosidered after 7-
10 days if unable to meet within
60% of energy requirment.
From ESPEN, receiving less than
rheur targeted enteral nutrition
after 2 days.
AFTER GASTROINTESTINAL
SURGERY EARLY ENTERAL
NUTRITION IS THE MAIN
STREAM
As shown in this slide doctor heres
a sample case showing the NEED
for SPN of BFLUID.
After GI Surgery, EN is still the
priority type of nutrition to
patients. Usually for short term
hospitalization seldom do patients
become deficient in EFA (essential
fatty acid) and patient usually
encounted deficiency in protein.
After naman po talaga
maoperahan doctor suggest
kumain paunti unti pero walang
gana si patient so may deficieny
pa din sa protein. With this, By
supplementing oral intake with
BFLUID injection it can prevent
the lost of protein , loss of
nitrogen could be avoided and
provide additional calorie to meet
your patient need per day.
INEVITABLE LOSS OF NITROGEN
CONTENT OF BFLUID
Again doctor, this are the content of
BFLUID for 500ml the patient can get 210
kCal also for 1000ml patient can get 420
kCal. BFluid also contains hight amount
of Protein (Amino Acid) 15g in 500ml and
30g in 1L that can compensate the
protein needed together with EN
(enteral) of oral feeding.
I also want to highlight doctor that
BFLUID is 2 chamber bag
Pinaghiwalay si amino acid and glucose
to prevent maillard reaction
(discoloration)
Also on the lower chamber doctor,
BFLUID has a lower amount of
potassium. Because high amount of
potassium given to patients can cause
HYPERKALEMIA and sometimes lead to
renal failure.
Good day Day Doctor please allow
me to share with you the
importance of vitamin B1?
Vitamin B1 helps the cells in the
body convert food into energy. If you
do not have enough vitamin B1 this
process cannot work properly. You
may have symptoms such as
tiredness, loss of appetite and muscle
weakness.
PRODUCTS FOR PPN AND
SOLUTION CONTAINING
CARBOHYDRATES AND
ELECTROLYTES
As shown in this slide doctor we
compare maintenance solution vs
BLUID.
They both have electrolytes and
cabohydrates, while in BFLUID it has
Vitamin B1 that during glycolysis
glucose is to be converted to pyruvic
acid and metabolized to Acetyl coA
needs the co enzyme which is Vit b1
(thiamine) without thiamine, pyruvic
acid will not be converted to Acetyl
coA (Its main function is to deliver the
acetyl group to the citric acid cycle to
be oxidized for energy production)
and will accumulate and will result
to lactic acidosis.
Lactic acidosis is a medical condition
characterized by the buildup of lactate
(especially L-lactate) in the body, with
formation of an excessively low pH in the
bloodstream. It is a form of metabolic acidosis,
in which excessive acid accumulates due to a
problem with the body's oxidative metabolism.
MAINTENANCE SOLUTIONS: Some
maintenance solution only have glucose
content, if the body already use glucose
for energy, but how about for muscle
repair. For this we need amino acid for
muscle repair to promote protein
synthesis. Its better to have glucose + at
the same time we have amino acid for
muscle repair. after surgery POST OP -
we need muscle repair for wound healing
its important to have protein content.
BFLUID is compose of
electrolytes,glucose,amino acid and
Vitamin B1
HAPPENS EVERY DAY, AMINO
ACID MUST BE ADMINISTERED
DAILY.
With this doctor if you give
BFLUID with Vitamin B1 and
amino acid. It will help prevent
the cause of lactic acidosis it also
allow the continous process of
glucose metabolism and will result
for the improvement of nitrogen balance
and improvement in protein synthesis.
If the nitrogen balance and protein
metabolism is improve we can prevent
postoperative complication. We all know
that amino acids have a role in
building and repairing body tissues,
which is critical to wound healing.
COMPARISON OF EACH
CONTENT
Bfluid doctor is available in 500ml and
1L Soft bag which contain
already .75mg and 1.5mg of thiamine.
By giving 2000mL or together with
oral/enteral feeding, your patient can
receive the daily thiamine requirment
as recommended by the aspen
guidelines.
UPPER-AMINO ACID
LOWER-
GLUCOSE,ELECTROLYTES,VITAMI
N B1
ISOLEUCINE
LEUCINE
VALINE
SHELF LIFE: 2YEARS,18MONTHS
MAXIMUM: 2.5liter,2500ML