Aluminum contamination of parenteral nutrition additives, amino acid solutions, and lipid emulsions.
Contamination of parenteral nutrition solutions with aluminum may result in accumulation of this element in bones and, in premature infants, may inhibit bone calcium uptake and induce cholestasis. We measured the aluminum concentration of small-volume parenterals, amino acid solutions, lipid emulsions, and special solutions containing glucose, amino acids, electrolytes, and trace elements (standard I for children with a body weight of 3-5 kg, standard II for children with a body weight of 5-10 kg). The method used was graphite furnace atomic absorption spectrometry GTA-AAS (SpectrAA-400 Plus, Varian, PtY Ltd., Mulgrave, Australia). Quality control was run with the use of control serum (Seronorm, Nycomed, Oslo, Norway). The aluminum contents of parenterally administered solutions were: pediatric trace elements, 130 micrograms/L, and pediatric trace elements, 3000 micrograms/L; phosphorus salts: K-phosphates, 9800 micrograms/L, and Na/K phosphates, 13,000 micrograms/L; 10% calcium gluconate, 4400 micrograms/L; 6.5% amino acids, 30 micrograms/L; 10% amino acids, 120 micrograms/L; 12.5% amino acids, 121 micrograms/L; 20% lipid emulsion, 30 micrograms/L; 20% lipid emulsion, 180 micrograms/L; water-soluble vitamins, 12 micrograms/L; lipid soluble vitamins, 360 micrograms/L; standard I, 55 micrograms/L; standard II, 90 micrograms/L; The aluminum intake from parenteral nutrition was 6.6-10.8 micrograms.kg-1.d-1--a dose exceeding the safety limit of 2 micrograms.kg-1.d-1. The possible association of aluminum not only with metabolic bone disease, but also with encephalopathy, dictates caution when dealing with the pediatric population on long-term parenteral nutrition. In the absence of reliable label information, it seems proper to monitor the aluminum concentration in parenteral nutrition products and to report it in professional journals.
Popińska
K
K
Children's Memorial Health Institute, Department of Gastroenterology and Nutrition, Warsaw, Poland.
Kierkuś
J
J
Lyszkowska
M
M
Socha
J
J
Pietraszek
E
E
Kmiotek
W
W
Ksiazyk
J
J
D000535:Aluminum / Q000032:analysis*; D000596:Amino Acids; D004340:Drug Contamination; D005217:Fat Emulsions, Intravenous / Q000032:analysis*; D006801:Humans; D010288:Parenteral Nutrition; D010372:Pediatrics; D012996:Solutions / Q000032:analysis*; D013054:Spectrophotometry, Atomic
D000596:Amino Acids; D005217:Fat Emulsions, Intravenous; D012996:Solutions; D000535:Aluminum