[Oxidation of lipids contained in total parental nutrition].
The components used in parenteral nutrition mixtures are subject to oxidation. The oxidation of polyunsaturated lipids leads to the formation of toxic lipoperoxides. This toxicity is of particular significance in new-born children, because of the lack of maturity of their defensive systems against oxidative processes, and also in critically-ill patients, whose oxidative metabolism is increased. A review of the literature is effected to assess the following: toxicity of lipoperoxides, factors involved in the oxidation of parenteral nutrition mixtures and the analytical methods used to determine the peroxides present in parenteral nutrition mixtures. The factors influencing the oxidation of parenteral nutrition mixtures include: the amount of polyunsaturated fatty acids, the presence of bisulphite, vitamin complexes and their polysorbate content, temperature, type of bag and exposure to light. The analytical methods found for the analysis of peroxides in TPN mixtures are: iodine measurement analysis, high resolution liquid chromatography, the thiobarbituric acid test, and oxidation of the ferrous cation in the presence of xylenol orange. Depending on the method, it is possible to determine total peroxides or only lipoperoxides. The literature reviewed does not establish a threshold level of peroxide concentration below which a parenteral nutrition mixture can be considered safe.
Balet Duat
M A
MA
Hospital Santa Cruz y San Pablo, Servicio de Farmacia, Barcelona, España.
Cardona Pera
D
D
D050356:Lipid Metabolism; D008055:Lipids / Q000032:analysis*; D010084:Oxidation-Reduction; D010289:Parenteral Nutrition, Total; D010545:Peroxides / Q000009:adverse effects; D012996:Solutions / Q000737:chemistry
D008055:Lipids; D010545:Peroxides; D012996:Solutions