Lipid Peroxidation of Intravenous Lipid Emulsions and All-in-One Admixtures in Total Parenteral Nutrition Bags: The Influence of Trace Elements

1. Balances of twenty trace elements (silver, arsenic, gold, bromine, cadmium, cobalt, chromium, caesium, copper, iron, mercury, lanthanum, molybdenum, rubidium, antimony, scandium, selenium, samarium, tungsten and zinc) have been determined in four male patients during total parenteral nutrition including fat emulsion and a special solution for addition of Fe, Zn, manganese, Cu, fluorine and iodine, besides calcium and magnesium, to the infusion solutions.2. The analyses for trace elements were made with the aid of an ion-exchange technique based on neutron activation, and combined with subsequent gamma spectrometry.3. The intended intravenous supply of trace elements corresponded approximately to the analysed supply. However, all the other trace elements determined were found to be unintentionally administered in small amounts.4. There was a substantial retention of Fe. Other elements retained were Ag, Co, Cr, Cu, Sb, Sc and W.5. Particularly Br and Rb were lost by the patients, but negative balances were also found for As, Au, Cd, Cs, Mo, Se and Zn. However, Zn was retained by one patient with short bowel syndrome.6. The serum concentrations of thirteen (Ag, Br, Co, Cs, Cu, Fe, Hg, Mo, Rb, Sc, Se, W and Zn) of the trace elements were found to have some decrease during the period of total parenteral nutrition, mostly in accordance with the corresponding balance values. Fe, in particular, was found to have the directional change in concentration.7. The administration of trace elements is recommended in long-term total parenteral nutrition.

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Do lipid emulsions. In total parenteral nutrition precipitate plasma fibronectin deficiency?

Clinical Nutrition ◽

10.1016/0261-5614(86)90195-0 ◽

1986 ◽

Vol 5 ◽

pp. 118

Keyword(s):

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Lipid Emulsions ◽

Plasma Fibronectin

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P0179 PP CELLULAR CHANGES IN RABBIT LIVER AFTER TOTAL PARENTERAL NUTRITION WITH THREE DIFFERENT LIPID EMULSIONS - AN ELECTRON MICROSCOPIC STUDY

Journal of Pediatric Gastroenterology and Nutrition ◽

10.1097/00005176-200406001-00303 ◽

2004 ◽

Vol 39 (Supplement 1) ◽

pp. S126-S127

Author(s):

M. Bendiks ◽

T. Wedel ◽

A. Entenmann ◽

J. Stuttmann ◽

M. Kohl

Keyword(s):

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Microscopic Study ◽

Electron Microscopic Study ◽

Rabbit Liver ◽

Lipid Emulsions ◽

Electron Microscopic ◽

Cellular Changes

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Effect of Lipid Emulsion on Stability of Ampicillin in Total Parenteral Nutrition

Nutrients ◽

10.3390/nu11030559 ◽

2019 ◽

Vol 11 (3) ◽

pp. 559 ◽

Cited By ~ 7

Author(s):

Maciej Stawny ◽

Aleksandra Gostyńska ◽

Katarzyna Dettlaff ◽

Anna Jelińska ◽

Eliza Główka ◽

...

Keyword(s):

Trace Elements ◽

Zeta Potential ◽

Parenteral Nutrition ◽

Total Parenteral Nutrition ◽

Lipid Emulsion ◽

Ph Value ◽

Droplet Diameter ◽

Physical Stability ◽

Light Protection ◽

The Impact

Background: Ampicillin (AMP) is frequently administered parenterally in critically ill patients with meningitis or endocarditis. Many of them require parallel infusion of total parenteral nutrition (TPN) admixtures. The aim of the study was to determine the physicochemical stability of AMP in TPN admixtures. Methods: AMP was added to two formulations of TPN admixtures differing in the lipid emulsion (Lipofundin® MCT/LCT 20% or LIPIDem®). Samples were stored at 4 ± 1 °C with light protection, and at 25 ± 1 °C with and without light protection to assess the impact of temperature and light on formulation stability. Every 24 h the pH, zeta potential, mean droplet diameter (MDD) of a lipid emulsion, and AMP concentration using HPLC method were determined. The assessment of stability and compatibility of TPN admixtures with vitamins and trace elements was carried out immediately after preparation and after 24 h of storage. Results: The addition of AMP as well as vitamins and trace elements to the TPN admixtures did not affect their physical stability. An increase in the pH value of approx. 0.6 and reduction of zeta potential were observed. The MDD of the lipid emulsions was below the limit of 500 nm (dynamic light scattering (DLS) method) and no fat droplets greater than 525 nm were observed (light diffraction (LD) method). The content of AMP after the first 24 h was within the acceptable limit of 90% for TPN admixtures stored at 4 ± 1 °C and 25 ± 1 °C with light protection. Conclusions: The results showed that co-administration of AMP in the same bag with TPN admixture at the tested dose is possible when used ex tempore and with light protection.

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