Photoprotection of Parenteral Nutrition for Premature Infants
Keywords:
parenteral nutrition, intravenous lipid emulsion, photoprotection, premature infants, oxidative stress, free radicalsAbstract
Parenteral nutrition (PN) is well known as the major source of energy and mandatory nutrients for sick neonates or when the enteral route is limited. Premature infants, who in great need for adequate nutrition to survive and catching up growth, highly depend on total parenteral solutions in their early life. Various parenteral nutrition preparations, however, may come with undesirable effects from contaminated oxidants when light protection is absent. Together with the immature antioxidant process and oxidative stress from therapy, a growing body of clinical evidence has observed the pathogenesis of complications associated with prematurity in preterm infants with parental nutrition, such as bronchopulmonary dysplasia, necrotizing enterocolitis, and retinopathy of prematurity. Protection of parenteral admixtures from light has shown to reduce incidence of complications and death in preterm infants and suggested by professional organizations,
namely the American Society for Parenteral and Enteral Nutrition (ASPEN), the European Society of Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN), and the European Society for Clinical Nutrition and Metabolism (ESPEN) to reduce the generation of peroxides and other degradation products. Despite recommendations for complete photoprotection of parenteral nutrition solutions, there are considerations and challenges in achieving full protection in every step from manufacturing, compounding, transferring, and finally administering PN to patients with the currently available materials and supplies.
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