Effects of multilayered bags vs ethylvinyl-acetate bags on oxidation of parenteral nutrition.
BACKGROUND
We evaluate the effects of multilayered bags vs ethylvinyl-acetate bags on peroxidate formation of various emulsions for all-in-one total parenteral nutrition solutions (TPN) during storage.


METHODS
Twenty-four parenteral nutritions were prepared with 4 commercial i.v. lipid emulsions (Soyacal 20%, Grifols; Intralipid 20%, Fresenius-Kabi; Lipofundina 20%, Braun; and Clinoleic 20%, Clintex) and 2 different bags (multilayered [ML] bag, Miramed; and 1 ethylvinyl-acetate [EVA] bag, Miramed). Each kind of TPN was prepared in triplicate. Samples were taken at 3 different times: immediately after preparation (time 0), after 6 days at 4 degrees C and 48 hours at 37 degrees C (time 1), and finally after a total of 14 days at 37 degrees C (time 2). Oxidation of TPN was evaluated by analysis of hydroperoxides by ferrous oxidation-xylenol orange (FOX) reactive, lipoperoxides by thiobarbituric acid reactive species (TBARS), alpha-tocopherol by high-performance liquid chromatography (HPLC), and ascorbic acid and dehydroascorbic acid by HPLC.


RESULTS
TPN admixtures in ML bag showed less oxidation evaluated by peroxide determination using FOX than EVA bag. Lipoperoxides by TBARS did not show significant differences between 2 bags. Ascorbic acid and dehydroascorbic acid disappeared in EVA bags at time 1. No important differences were found in alpha-tocopherol content.


CONCLUSIONS
Multilayered bags minimize oxidation.
Balet
Antònia
A
Pharmacy Service, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
Cardona
Daniel
D
Jané
Salvador
S
Molins-Pujol
Antoni M
AM
Sánchez Quesada
José Luís
JL
Gich
Ignasi
I
Mangues
Ma Antònia
MA
D001205:Ascorbic Acid / Q000032:analysis / Q000737:chemistry; D002851:Chromatography, High Pressure Liquid; D003683:Dehydroascorbic Acid / Q000032:analysis / Q000737:chemistry; D004349:Drug Packaging; D004355:Drug Stability; D004356:Drug Storage; D005526:Food, Formulated / Q000032:analysis*; D006801:Humans; D010084:Oxidation-Reduction; D010288:Parenteral Nutrition / Q000295:instrumentation* / Q000379:methods; D013696:Temperature; D017392:Thiobarbituric Acid Reactive Substances / Q000032:analysis / Q000737:chemistry; D013997:Time Factors; D024502:alpha-Tocopherol / Q000032:analysis / Q000737:chemistry
D017392:Thiobarbituric Acid Reactive Substances; D024502:alpha-Tocopherol; D001205:Ascorbic Acid; D003683:Dehydroascorbic Acid