Incidence of hypertriglyceridemia in critically ill neonates receiving lipid injectable emulsions in glass versus plastic containers: a retrospective analysis.
OBJECTIVE
To evaluate plasma clearance of lipid injectable emulsions packaged in either glass or plastic containers in neonates from 2 7-month periods, 1 year apart.


METHODS
Clinical records from June 1 to December 31, 2003 (glass [G] period) and the same months in 2004 (plastic [P] period) were assessed. Neonates who received lipid injectable emulsions were studied. Lipid container (glass vs plastic) was the independent variable.


RESULTS
Of the 197 patients studied, 122 (G, 50/81; P, 72/116) had evaluable triglyceride (TG) levels, for an overall rate of 62%. Only birth weight (G, 1.09 +/- 0.32 kg vs P, 1.23 +/- .45 kg) and birth length (G, 36.4 +/- 3.5 cm vs P, 37.9 +/- 3.5 cm) were significantly different between the 2 groups (P = .047 and .028, respectively). There were no differences in the day of life on which lipid injection was started, the lipid dose, or the timing of TG measurements. The incidence of hypertriglyceridemia was significantly higher in the P period (G, 3/50 vs P, 19/72; P = .004).


CONCLUSIONS
Administration of the same lipid formulation in plastic bags compared with glass containers is associated with higher rates of hypertriglyceridemia. The poorer clearance of lipids could be due to a higher proportion of large-diameter fat globules in plastic bags compared with those in glass containers.
Martin
Camilia R
CR
Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Dumas
Gregory J
GJ
Shoaie
Claire
C
Zheng
Zheng
Z
Mackinnon
Brenda
B
Al-Aweel
Issa
I
Bistrian
Bruce R
BR
Pursley
DeWayne M
DM
Driscoll
David F
DF
D004349:Drug Packaging; D004355:Drug Stability; D005217:Fat Emulsions, Intravenous / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005898:Glass; D006801:Humans; D015228:Hypertriglyceridemia / Q000453:epidemiology / Q000209:etiology*; D007231:Infant, Newborn; D008055:Lipids / Q000737:chemistry; D008297:Male; D016017:Odds Ratio; D010289:Parenteral Nutrition, Total / Q000379:methods; D010969:Plastics; D012189:Retrospective Studies; D013997:Time Factors; D014280:Triglycerides / Q000378:metabolism
D005217:Fat Emulsions, Intravenous; D008055:Lipids; D010969:Plastics; D014280:Triglycerides