Trace element contamination of total parenteral nutrition. 1. Contributionof component solutions

Background: Trace elements have been shown to contaminate total parenteral nutrition (TPN) solutions. Methods: This study used the multi-elemental tec hnology of inductively coupled plasma-mass spectrometry to demonstrate the extent to which trace elements were present in amounts above tie, as contam inants) or below expected levels in eight TPN component solutions. Results: Of the 66 trace elements scanned, there were 12 trace element contaminants in amounts >1 mu g/L (zinc, copper, manganese, chromium, selenium, boron, aluminum, titanium, barium, vanadium, arsenic, and strontium) in the eight component solutions studied. Trace element contaminants were present in all solutions, and different trace elements contaminated the solutions at vari ous concentrations. Component solutions of amino acid, potassium chloride, calcium gluconate, and sodium chloride contained the greatest numbers of tr ace element contaminants, whereas the lowest numbers were present in steril e water and magnesium sulfate. Interlot and intermanufacturer variations we re apparent. Measured concentrations of trace elements in the multi-trace e lement additive solution also were higher than the labeled values. A compar ison of the amounts of contaminated trace elements delivered by a typical T PN mixture relative to the amounts typically absorbed by the gastrointestin al tract indicates that the inadvertent delivery of trace elements from con taminated TPN solutions may be substantial. Conclusions: AU eight component s tested were contaminated with trace elements not intended to be present i n the product, and similarly, the multi-trace element component contained t race elements either above or below that which the label claimed.