Contribution of multivitamins, air, and light in the generation of peroxides in adult and neonatal parenteral nutrition solutions

OBJECTIVE: To compare the concentrations of peroxides between adult and neo natal total parenteral nutrition (TPN) solutions in response to protection against inducers of peroxidation such as multivitamins and exposure to ligh t or air. METHODS: Peroxide concentrations were measured in freshly prepared adult an d neonatal solutions of fat-free TPN in four settings: with or without an a ir inlet, and protected or unprotected from ambient light. An oxygen washou t was performed by exposing a fat-free neonatal TPN solution to a continuou s flow of nitrogen. RESULTS: Globally, light was the main inducer of peroxides in adult and neo natal solutions. However, in adult solutions the concentration of peroxides remained <15 mu mol/L, while in neonatal solutions the peroxide concentrat ion was as high as 300 mu mol/L in ambient light. Although the oxygen washo ut did prevent the generation of peroxides, avoiding air inlet was not as e ffective as was photoprotection in decreasing the important peroxide toad i n the neonatal TPN solution. CONCLUSIONS: The higher concentration of peroxides found in neonatal soluti ons compared with adult solutions is explained by the differences in nutrie nt composition between the two solutions. Contamination of parenteral solut ions by air during compounding accounts for the photoinduced generation of peroxides in TPN solutions. It is more convenient to protect TPN solutions from light exposure after the admixture of the multivitamin solution than t o avoid contact with oxygen.