Aluminum contamination of parenteral nutrition additives, amino acid solutions, and lipid emulsions

Contamination of parenteral nutrition solutions with aluminum may result in accumulation of this element in bones and, in premature infants, may inhib it bone calcium uptake and induce cholestasis. We measured the aluminum con centration of small-volume parenterals, amino acid solutions, lipid emulsio ns, and special solutions containing glucose, amino acids. electrolytes, an d trace elements (standard I for children with a body weight of 3-5 kg, sta ndard LI for children with a body weight of 5-10 kg). The method used was g raphite furnace atomic absorption spectrometry GTA-AAS (SpectrAA-400 Plus, Varian, PtY Ltd., Mulgrave, Australia). Quality control was run with the us e of control serum (Seronorm, Nycomed, Oslo, Norway). The aluminum contents of parenterally administered solutions were: pediatric trace elements, 130 mu g/L, and pediatric trace elements, 3000 mu g/L; phosphorus salts: K-pho sphates, 9800 mu g/L, and Na/K phosphates. 13 000 mu g/L; 10% calcium gluco nate, 4400 mu g/L; 6.5% amino acids, 30 mu g/L; 10% amino acids, 120 mu g/L ; 12.5% amino acids. 121 mu g/L; 20% lipid emulsion, 30 mu g/L; 20% lipid e mulsion, 180 mu g/L; water-soluble vitamins, 12 mu g/L; lipid soluble vitam ins, 360 mu g/L; standard I, 55 mu g/L; standard II, 90 mu g/L. The aluminu m intake from parenteral nutrition was 6.6-10.8 mu g.kg(-1).d(-1)-a dose ex ceeding the safety limit of 2 mu g.kg(-1).d(-1). The possible association o f aluminum not only with metabolic bone disease, but also with encephalopat hy, dictates caution when dealing with the pediatric population on long-ter m parenteral nutrition. In the absence of reliable label information, it se ems proper to monitor the aluminum concentration in parenteral nutrition pr oducts and to report it in professional journals. (C) Elsevier Science Inc. 1999.