title: Shielding Parenteral Nutrition Solutions From Light: A Randomized Controlled Trial.
abstract: BACKGROUND
  Oxidant stress is implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Light induces peroxide generation in parenteral nutrition (PN) solutions, creating an oxidant stress. Shielding PN from light decreases its peroxide content, which has nutrition and biochemical benefits in animals and humans. This study aims at determining whether full light protection of PN decreases the rate of bronchopulmonary dysplasia and/or death in very low-birth-weight infants.
  
  
  METHODS
  Multicenter randomized controlled trial of photoprotection, using amber bags and tubing initiated during compounding of PN and maintained throughout infusion in the light-protected (LP) group. The control group (light exposed [LE]) received PN exposed to ambient light. Depending on centers, lipids were infused either separately or as all-in-one PN.
  
  
  RESULTS
  In total, 590 infants born <30 weeks gestational age were included. At randomization, LE and LP groups did not differ clinically except for maximal FiO2 before 12 hours. The rate of BPD/death was not different between groups at 28 days (77% LP vs 72% LE, P = .16) or at 36 weeks corrected age (30% LP vs 27% LE, P = .55). Multivariate analysis showed no significant effect of photoprotection on BPD and/or death. The rate of BPD/death was significantly lower (odds ratio, 0.54; 95% confidence interval, 0.32-0.93; P = .02) in infants receiving all-in-one PN vs those who received lipids separately.
  
  
  CONCLUSIONS
  This study did not show significant beneficial effects of photoprotection. Since the decreased rate of BPD/death found with all-in-one PN relates to a center-dependent variable, this warrants further investigation.
authors.affiliation: Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France Hospices Civils de Lyon-Centre Hospitalier Lyon Sud, Pierre-Bénite, France sophie.laborie@gmail.com.
authors.forename: Sophie
authors.initials: S
authors.lastname: Laborie
authors.affiliation: Hospices Civils de Lyon, Lyon, France.
authors.forename: Angélique
authors.initials: A
authors.lastname: Denis
authors.affiliation: Centre Hospitalier Intercommunal de Créteil, Créteil, France.
authors.forename: Gilles
authors.initials: G
authors.lastname: Dassieu
authors.affiliation: Centre Hospitalier Universitaire de Limoges, Limoges, France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Bedu
authors.affiliation: Centre Hospitalier Universitaire, Amiens, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Tourneux
authors.affiliation: Centre Hospitalier Universitaire-Hôpital Charles-Nicolle, Rouen, France.
authors.forename: Didier
authors.initials: D
authors.lastname: Pinquier
authors.affiliation: Assistance Publique/Hôpitaux de Paris-Hôpital Necker-Enfants Malades, Paris, France Université Paris Descartes, Paris, France.
authors.forename: Elsa
authors.initials: E
authors.lastname: Kermorvant
authors.affiliation: Assistance Publique-Hôpitaux de Marseille-Hôpital de la Conception, Marseille, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Millet
authors.affiliation: Centre Hospitalier de Lens, Lens, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Klosowski
authors.affiliation: Centre Hospitalier Universitaire de Saint Etienne, Saint Etienne, France.
authors.forename: Hugues
authors.initials: H
authors.lastname: Patural
authors.affiliation: Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Clamadieu
authors.affiliation: Hôpital de la Côte Basque, Bayonne, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Brunhes
authors.affiliation: Centre Hospitalier de Chambéry, Chambéry, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Walther
authors.affiliation: Hospices Civils de Lyon, Lyon, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Jaisson-Hot
authors.affiliation: Hospices Civils de Lyon, Hôpital René Sabran, Giens, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Mandy
authors.affiliation: Hospices Civils de Lyon, Hôpital Femme Mère Enfant, Bron, France Hospices Civils de Lyon-Centre Hospitalier Lyon Sud, Pierre-Bénite, France Université Claude Bernard Lyon 1, Lyon, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Claris
mesh_terms: D001997:Bronchopulmonary Dysplasia / Q000473:pathology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight / Q000254:growth & development; D007363:Intensive Care Units, Neonatal; D008027:Light / Q000009:adverse effects*; D008297:Male; D015999:Multivariate Analysis; D018384:Oxidative Stress; D057947:Parenteral Nutrition Solutions / Q000737:chemistry / Q000528:radiation effects*; D010545:Peroxides / Q000737:chemistry; D011446:Prospective Studies; D011835:Radiation Protection / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D057947:Parenteral Nutrition Solutions; D010545:Peroxides
keywords: bronchopulmonary dysplasia; parenteral nutrition; peroxides; preterm infant; very low birth weight