Influence of Vitamins, Trace Elements, and Iron on Lipid Peroxidation Reactions in All-in-One Admixtures for Neonatal Parenteral Nutrition

• Published in: JPEN. Journal of parenteral and enteral nutrition 2011-07, Vol.35 (4), p.505-510
• Main Authors: Grand, Anaïs, Jalabert, Anne, Mercier, Grégoire, Florent, Maurice, Hansel-Esteller, Sylvie, Cambonie, Gilles, Steghens, Jean-Paul, Picaud, Jean-Charles
• Format: Article
• Language: English
• Subjects: Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Diseases of the digestive system; Emergency and intensive care: metabolism and nutrition disorders. Enteral and parenteral nutrition; Humans; Infant, Newborn; Intensive care medicine; Iron - analysis; Lipid Peroxidation; Malondialdehyde - analysis; Medical sciences; neonates; nutrition; parenteral nutrition; Parenteral Nutrition - methods; Parenteral Nutrition Solutions - chemistry; prematurity; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Trace Elements - analysis; Vitamins - analysis
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/0148607110381768

Background: The purpose of this study was to evaluate the effect of vitamins, trace elements, or iron on lipid peroxidation in all-in-one parenteral nutrition (PN) admixtures for preterm neonates. Methods: Malondialdehyde (MDA) concentrations were analyzed over a 24-hour period (H1-H24) in lipid-containing PN solutions that have a composition identical to that used in the routine clinical care of preterm infants. Six different solutions were prepared and evaluated when exposed to ambient light and light-protected conditions as follows: control (without vitamins [Vit], trace elements [TE], or iron [Fe] [Vit−TE−Fe−]), solution 1 (Vit+TE+Fe−), solution 2 (Vit+TE−Fe−), solution 3 (Vit−TE+Fe−), solution 4 (Vit−TE−Fe+), and solution 5 (Vit+TE+Fe+). Results: MDA concentrations in PN solutions were significantly higher at H24 than at H0 when they contained multivitamins (P < .001), trace elements (P = .002), or iron saccharate (P = .018). MDA concentration was particularly high when all 3 micronutrients were present (P < .001) or when the solutions were exposed to ambient light. In solutions containing iron, MDA concentrations were elevated at H0, and levels did not change whether protected from (P < .001) or exposed to (P < .001) from light. Conclusions: The addition of vitamins and trace elements to PN solutions induces a significant increase in peroxidation products, which are lowered when admixtures are protected from light. Iron should not be included in these solutions, even if solutions are light-protected. By following these conditions it is possible to use all-in-one admixtures in the nutrition management of preterm infants.