title: Influence of vitamins, trace elements, and iron on lipid peroxidation reactions in all-in-one admixtures for neonatal parenteral nutrition.
abstract: BACKGROUND
  The purpose of this study was to evaluate the effect of vitamins, trace elements, or iron on lipid peroxidation in all-in-one parenteral nutrition (PN) admixtures for preterm neonates.
  
  
  METHODS
  Malondialdehyde (MDA) concentrations were analyzed over a 24-hour period (H1-H24) in lipid-containing PN solutions that have a composition identical to that used in the routine clinical care of preterm infants. Six different solutions were prepared and evaluated when exposed to ambient light and light-protected conditions as follows: control (without vitamins [Vit], trace elements [TE], or iron [Fe] [Vit-TE-Fe-]), solution 1 (Vit+TE+Fe-), solution 2 (Vit+TE-Fe-), solution 3 (Vit-TE+Fe-), solution 4 (Vit-TE-Fe+), and solution 5 (Vit+TE+Fe+).
  
  
  RESULTS
  MDA concentrations in PN solutions were significantly higher at H24 than at H0 when they contained multivitamins (P < .001), trace elements (P = .002), or iron saccharate (P = .018). MDA concentration was particularly high when all 3 micronutrients were present (P < .001) or when the solutions were exposed to ambient light. In solutions containing iron, MDA concentrations were elevated at H0, and levels did not change whether protected from (P < .001) or exposed to (P < .001) from light.
  
  
  CONCLUSIONS
  The addition of vitamins and trace elements to PN solutions induces a significant increase in peroxidation products, which are lowered when admixtures are protected from light. Iron should not be included in these solutions, even if solutions are light-protected. By following these conditions it is possible to use all-in-one admixtures in the nutrition management of preterm infants.
authors.affiliation: CHU Montpellier, Pharmacie, Hopital Lapeyronie, Montpellier, France.
authors.forename: Anaïs
authors.initials: A
authors.lastname: Grand
authors.forename: Anne
authors.initials: A
authors.lastname: Jalabert
authors.forename: Grégoire
authors.initials: G
authors.lastname: Mercier
authors.forename: Maurice
authors.initials: M
authors.lastname: Florent
authors.forename: Sylvie
authors.initials: S
authors.lastname: Hansel-Esteller
authors.forename: Gilles
authors.initials: G
authors.lastname: Cambonie
authors.forename: Jean-Paul
authors.initials: JP
authors.lastname: Steghens
authors.forename: Jean-Charles
authors.initials: JC
authors.lastname: Picaud
mesh_terms: D006801:Humans; D007231:Infant, Newborn; D007501:Iron / Q000032:analysis*; D015227:Lipid Peroxidation; D008315:Malondialdehyde / Q000032:analysis; D010288:Parenteral Nutrition / Q000379:methods*; D057947:Parenteral Nutrition Solutions / Q000737:chemistry*; D014131:Trace Elements / Q000032:analysis*; D014815:Vitamins / Q000032:analysis*
chemical_list: D057947:Parenteral Nutrition Solutions; D014131:Trace Elements; D014815:Vitamins; D008315:Malondialdehyde; D007501:Iron