Shielding Parenteral Nutrition Solutions From Light
- 12 June 2014
- journal article
- research article
- Published by Wiley in Journal of Parenteral and Enteral Nutrition
- Vol. 39 (6) , 729-737
Abstract
Introduction: Oxidant stress is implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Light induces peroxide generation in parenteral nutrition (PN) solutions, creating an oxidant stress. Shielding PN from light decreases its peroxide content, which has nutrition and biochemical benefits in animals and humans. This study aims at determining whether full light protection of PN decreases the rate of bronchopulmonary dysplasia and/or death in very low-birth-weight infants. Methods: Multicenter randomized controlled trial of photoprotection, using amber bags and tubing initiated during compounding of PN and maintained throughout infusion in the light-protected (LP) group. The control group (light exposed [LE]) received PN exposed to ambient light. Depending on centers, lipids were infused either separately or as all-in-one PN. Results: In total, 590 infants born 2 before 12 hours. The rate of BPD/death was not different between groups at 28 days (77% LP vs 72% LE, P = .16) or at 36 weeks corrected age (30% LP vs 27% LE, P = .55). Multivariate analysis showed no significant effect of photoprotection on BPD and/or death. The rate of BPD/death was significantly lower (odds ratio, 0.54; 95% confidence interval, 0.32–0.93; P = .02) in infants receiving all-in-one PN vs those who received lipids separately. Conclusion: This study did not show significant beneficial effects of photoprotection. Since the decreased rate of BPD/death found with all-in-one PN relates to a center-dependent variable, this warrants further investigation.Keywords
This publication has 41 references indexed in Scilit:
- Outcomes of extremely low birth weight infants with bronchopulmonary dysplasia: Impact of the physiologic definitionEarly Human Development, 2012
- Preterm Resuscitation With Low Oxygen Causes Less Oxidative Stress, Inflammation, and Chronic Lung DiseasePediatrics, 2009
- Validation of the National Institutes of Health Consensus Definition of Bronchopulmonary DysplasiaPediatrics, 2005
- Impact of a Physiologic Definition on Bronchopulmonary Dysplasia RatesPediatrics, 2004
- Effect of blood transfusion on lipid peroxidation in preterm infants: Table 1Archives of Disease in Childhood - Fetal and Neonatal Edition, 2002
- Blood transfusion increases radical promoting non-transferrin bound iron in preterm infantsArchives of Disease in Childhood - Fetal and Neonatal Edition, 2001
- Alterations in antioxidant status during neonatal sepsisPaediatrics and International Child Health, 2000
- Paradoxical Role of Ascorbic Acid and Riboflavin in Solutions of Total Parenteral Nutrition: Implication in Photoinduced Peroxide GenerationPediatric Research, 1998
- Admixture of a Multivitamin Preparation to Parenteral Nutrition: The Major Contributor to In Vitro Generation of PeroxidesPediatrics, 1997
- Oxidation of parenteral lipid emulsion by ambient and phototherapy lights: Potential toxicity of routine parenteral feedingThe Journal of Pediatrics, 1995