Limiting light-induced lipid peroxidation and vitamin loss in infant parenteral nutrition by adding multivitamin preparations to Intralipid

Parenteral lipids are susceptible to light-induced peroxidation, particular ly under phototherapy. Ascorbic acid is protective. The aim of this study w as to investigate whether dark delivery tubing and/or coadministration of m ultivitamin preparations could prevent peroxidation of Intralipid without u ndue vitamin loss. In experiments carried out on the benchtop, lipid peroxi dation occurred in ambient light and was more extensive under phototherapy. Dark tubing decreased peroxide formation, but only by about 65%. In simula ted clinical conditions in which solutions were pumped through standard cle ar or dark minibore plastic tubing, Intralipid accumulated lipid peroxides as measured by the FOX assay (280 muM) or as triglyceride hydroperoxides (5 .2 muM). Multivitamin preparations (MVIP or Soluvit/Vitlipid) inhibited per oxide formation almost completely. and were fully protective when used with dark tubing, There was loss of riboflavin (65% from Soluvit and 35% from M VIP) in clear tubing but this was decreased to 18% and 11%, respectively, i n dark tubing. Ascorbate loss was 20% (MVIP) and 50% (Soluvit) and only sli ghtly less in dark tubing. Ascorbate loss was also seen in the absence of I ntralipid and is due to riboflavin-induced photo-oxidation. Conclusion: Multivitamin preparations protect Intralipid against light-indu ced formation of lipid hydroperoxides, and administering multivitamins with Intralipid via dark delivery tubing provides a practical way of preventing peroxidation of the lipid while limiting vitamin loss. This procedure shou ld be considered for routine use as well as with with phototherapy.