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Oct 14, 2018

7th Congress of the European Academy of Paediatric Societies

07 - SEPARATING AND SHIELDING MULTIVITAMINS TO REDUCE TOXIC PEROXIDES CONTAMINATING THE PARENTERAL NUTRITION (SMART-PN): IN VITRO STUDY

neonatology

preterm infants

oxidative stress

parenteral nutrition

photo-protection

peroxides

Abstract

Abstract

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Keywords

neonatology

preterm infants

oxidative stress

parenteral nutrition

photo-protection

peroxides

Abstract

Background and Aims: Parenteral nutrition (PN) is necessary to extremely preterm infants. PN contamination with peroxides was confirmed. Multivitamins (MV) and PN light exposure are the 2 main inducers of peroxide contamination. PN complete photo-protection in research settings resulted in 50% reduction in PN and urinary peroxides. In preterm infants, complete photo-protection resulted in 20-30% reduction of BPD (2 uni-center RCTs), while no significant effect in one multi-center RCT. Recent meta-analysis found 50% reduction in mortality with photo-protection. Complete whole PN photo-protection is impossible in routine clinical settings. We hypothesize that shielding and infusing MV in a separate line could be a practical alternative. Our objective is to compare peroxides contamination of PN with and without this intervention. Methods: The MV was sampled in a photo-protected syringe. This syringe was installed in a pump and connected to photo-protected separate extension line (LS688 Light-Safe® Minibore Extension Set) that is connected to a photo-protected trifurcate connection (LS230 Trifurcated Light-Safe® Minibore Extension Set) directly infusing to the patient. Results: In absence of photo-protection, peroxides in the syringe increased from 97±10 μM at vial opening to 198±18 μM at time of connection to the intravenous line (30 min later) (n=3), while peroxides remained stable at 109±11 μM with the intervention (n=3). When adding the generated peroxides over 5 hours (Samples at times 0, 0.5, 1, 3 and 5 hours), total peroxides were 1270± 47 μM without photo-protection vs. 710±16 μM with intervention. Conclusion: Shielding and infusing MV in a separate line provide readily applicable and effective method of photo-protection.

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© Copyright 2019 Morressier GmbH.
All rights reserved.