Delivery of Vitamin A from parenteral nutrition solutions in neonates

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Abstract
The delivery of Vitamin A from parenteral nutrition may be suboptimal. To Investigate this sample solutions were prepared and Vitamins A and E concentrations from the solution bags and the efflux from the lines were measured over a 24 h period. The results show that mean Vitamin A levels in the solution bags declined from a range of 57‐66% to 17% of expected over 24 h and at the efflux of the lines from a range of 13‐29% to 4% of expected, giving a calculated delivery of 10% of expected. There is no improvement with light protection or an ethylene vinyl acetate system. Mixing the vitamin preparation in lipid showed less decline (from 92 to 70% of expected over 24 h), but the delivery was variable. When vitamins were added to a lipid‐dextrose‐amino acid solution, there was minimal loss from the solution bag and line with a calculated delivery of 94% of expected. The delivery of Vitamin E from all systems was constant with a mean calculated delivery of 74% of expected.It was concluded that the mixing of multivitamins in dextrose‐amino acid‐electrolyte solutions results in poor delivery of Vitamin A and this is improved by mixing in lipid solution. This is important in preterm infants who are prone to become Vitamin A deficient.

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