Cholesterol oxidation in intravenous lipid emulsions: safety of preparations before and after experimental hyperoxia

• Published in: JPEN. Journal of parenteral and enteral nutrition 2004-09, Vol.28 (5), p.342-347
• Main Authors: Scopesi, F, Zunin, P, Bellini, C, Sacchi, R, Boggia, R, Evangelisti, F, Serra, G
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood. Blood and plasma substitutes. Blood products. Blood cells. Blood typing. Plasmapheresis. Apheresis; Cholesterol - metabolism; Diseases of the digestive system; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Fat Emulsions, Intravenous - analysis; Fat Emulsions, Intravenous - chemistry; Fatty Acids; Gas Chromatography-Mass Spectrometry; Humans; In Vitro Techniques; Intensive care medicine; Lipid Peroxidation - drug effects; Medical sciences; Oxidation-Reduction; Oxygen - metabolism; Oxygen - pharmacology; Parenteral Nutrition - instrumentation; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Safety; Time Factors; Transfusions. Complications. Transfusion reactions. Cell and gene therapy
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/0148607104028005342

The aim of this preliminary study was to assess the possible presence of cholesterol oxidation products in 2 i.v. lipidic emulsions with different fatty acid compositions (long-chain triglyceride, medium-chain triglyceride-long-chain triglyceride). Because these emulsions are currently used in neonatal parenteral nutrition, their direct venous introduction might be potentially dangerous because of the possible atherogenic role of cholesterol oxidation products. The emulsions were analyzed when bottles were opened (ie, under normal condition of administration) and after a 12-hour direct experimental exposure to air and high (90%) oxygen concentrations. 7-Ketocholesterol and 5alpha-epoxycholesterol were chosen as markers of cholesterol oxidation and detected by gas chromatography-mass spectrometry of their trimethylsilyl ethers. The detected amounts were always very low and in some cases below the detection limit of the analytical method for the 2 cholesterol oxidation products (COPs; 0.1 and 0.3 microg/g of extracted lipids). Immediately after opening the bottles, their concentrations were lower in the emulsions containing the higher amounts of polyunsaturated fatty acids. Experimental hyperoxic exposure generally determined only a mild increase in the content of cholesterol oxidation biomarker, and after exposure to oxygen, the amounts of COPs were slightly higher than after exposure to air. The results of the present study are undoubtedly reassuring for the safety of neonates, although caution is always required when drawing conclusions from in vitro data.