title: Physicochemical stability of parenteral nutrition supplied as all-in-one for neonates.
abstract: BACKGROUND
  Common clinical practice for the provision of parenteral nutrition of neonates is to administer the nutrients in separate solutions. The aim of this study was to introduce and examine an alternative way of parenteral feeding for neonates, providing all-in-one parenteral regimes.
  
  
  METHODS
  Stability studies were carried out on 2 all-in-one admixtures. Stability assays consisted of the assessment of the admixture's (1) macroscopic aspect, (2) drop size measurement, (3) pH measurement, (4) peroxide value, and (5) alpha-tocopherol concentration. For the measurements, the admixtures were stored at 2 different temperatures, 4 degrees C (storage) and 25 degrees C (compounding), and then analyzed at a starting time, 24 hours, 48 hours, and 7 days after compounding.
  
  
  RESULTS
  The 2 all-in-one parenteral admixtures for neonates were shown to be physically stable under analysis conditions, and there were no particles larger than 1 mum. The maximum loss of alpha-tocopherol was approximately 24%. In all-in-one admixtures, lipid peroxide occurred within 24 hours after the addition of the lipid emulsion.
  
  
  CONCLUSIONS
  The addition of fat emulsion and fat-soluble vitamins did not alter the physical stability of parenteral admixtures for neonates. Moreover, the admixtures examined were relatively chemically stable for 24 hours, as far as vitamin E is concerned. Lipid peroxidation was the limiting factor for application stability of an all-in-one neonatal parenteral regimen.
authors.affiliation: Harokopio University, IASO Maternity Hospital, Athens, Greece. silia1000@yahoo.gr
authors.forename: Maria
authors.initials: M
authors.lastname: Skouroliakou
authors.forename: Chrysoula
authors.initials: C
authors.lastname: Matthaiou
authors.forename: Antonia
authors.initials: A
authors.lastname: Chiou
authors.forename: Demosthenes
authors.initials: D
authors.lastname: Panagiotakos
authors.forename: Antonis
authors.initials: A
authors.lastname: Gounaris
authors.forename: Tony
authors.initials: T
authors.lastname: Nunn
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Andrikopoulos
mesh_terms: D004355:Drug Stability; D004356:Drug Storage; D005865:Gestational Age; D006801:Humans; D006863:Hydrogen-Ion Concentration; D007227:Infant Nutritional Physiological Phenomena; D007231:Infant, Newborn / Q000254:growth & development*; D015227:Lipid Peroxidation; D010288:Parenteral Nutrition / Q000592:standards*; D010316:Particle Size; D010545:Peroxides / Q000032:analysis; D013696:Temperature; D013997:Time Factors; D024502:alpha-Tocopherol / Q000032:analysis
chemical_list: D010545:Peroxides; D024502:alpha-Tocopherol