Mm. Pluhator-murton et al., Trace element contamination of total parenteral nutrition. 2. Effect of storage duration and temperature, J PARENT EN, 23(4), 1999, pp. 228-232
Background: Patients who receive home total parenteral nutrition (TPN) freq
uently are supplied with solutions up to 30 days in advance of anticipated
use. The purpose of this study was to determine the stability of trace elem
ents relative to time and temperature conditions, in a typical adult TPN so
lution stored in a usual home environment by examining variations in delive
ry of intended trace elements and inadvertent trace element contamination.
Methods: Trace element concentrations were determined using inductively cou
pled plasma-mass spectrometry technology. The effect of the delivery appara
tus, storage duration (36 hours or 30 days) after compounding, and storage
temperature (4 degrees C or 20 degrees C) were examined. Results: The deliv
ery apparatus contaminated the delivered TPN solution with cobalt but did n
ot alter trace elements formulated into the TPN solution. Storage duration
and temperature significantly decreased three (Zn, Cu, and Mn) of the six t
race elements formulated into the TPN solution. Higher temperatures and lon
ger duration of storage accelerated this decrease. Boron, Al, V, Ti, Pa, Sr
, and CO were the trace elements that appeared as contaminants during stora
ge. Boron, Al, V, and Ti contamination decreased with higher temperatures a
nd longer duration of storage. Conclusions: Longer storage duration and hig
her storage temperature progressively reduced the deliverable concentration
s of trace elements specifically formulated into the TPN solution and also
of those trace elements that were not formulated into the TPN solution but
that appeared as contaminants.