Physical characteristics of total parenteral nutrition bags significantly affect the stability of vitamins C and B1: a controlled prospective study

Article Article scientifique Article Physical characteristics of total parenteral nutrition bags significantly affect the stability of vitamins C and B1: a controlled prospective study eng 2002-09 author Dupertuis Yves Marc 0000-0003-4891-0487 24489 author Morch Agnès 513871 author Fathi Marc 565078 author Sierro Christian David 31724 author Genton Graf Laurence 0000-0002-0037-5203 514243 author Kyle Ursula G author Pichard Claude 21908 310-316 10.1177/0148607102026005310 12216712 0148-6071 https://pubmed.ncbi.nlm.nih.gov/12216712/ Background: Vitamin degradation occurring during the storage of total parenteral nutrition (TPN) mixtures is significant and affects clinical outcome. This study aimed to assess the influence of the TPN bag material, the temperature, and the duration of storage on the stability of different vitamins. Methods: Solutions of multivitamin and trace elements at recommended doses were injected into either an ethylvinyl acetate (EVA) bag or a multilayered (ML) bag filled with 2500 mL of an identical mixture of carbohydrates (1200 kcal), fat (950 kcal), and amino acids (380 kcal). The bags were then stored at 4 degrees C, 21 degrees C, or 40 degrees C. Concentrations of vitamins A, B1, C, and E were measured up to 72 hours after compounding, using high-pressure liquid chromatography. Results: Ten percent to 30% of vitamin C degradation occurred within the first minutes after TPN compounding. Vitamin C was more stable in ML bags (half-life: 68.6 hours at 4 degrees C, 24.4 hours at 21 degrees C, and 6.8 hours at 40 degrees C) than in EVA bags (half-life: 7.2 hours at 4 degrees C, 3.2 hours at 21 degrees C, and 1.1 hour at 40 degrees C). Moreover, appearance of dehydroascorbic acid in the TPN mixture did not compensate for vitamin C losses. Vitamin B1 was stable at 21 degrees C, but a 43% loss occurred at 40 degrees C after 72-hour storage in EVA bags. The other vitamins were stable in the TPN mixture stored in both bags at any temperature and without daylight protection. Conclusions: Degradations of vitamins C and B, are significantly reduced in ML bags compared with EVA bags. To prevent vitamin C deficiencies, its initial dose should be adapted to its degradation rate, which depends on the TPN bag material, the ambient temperature, and the length of time between TPN compounding and the end of infusion to the patient. Ascorbic Acid / chemistry Chromatography, High Pressure Liquid Dehydroascorbic Acid / analysis Dehydroascorbic Acid / metabolism Diterpenes Drug Packaging Drug Stability Half-Life Humans Parenteral Nutrition, Total Prospective Studies Retinyl Esters Temperature Thiamine / chemistry Time Factors Vitamin A / analogs & derivatives Vitamin A / chemistry Alpha-Tocopherol / chemistry Dewey 616 Dewey 617 56 Département de médecine 221 63 Département d'anesthésiologie, pharmacologie, soins intensifs et urgences 229 false 1386 Nutrition et chronobiologie 1038 JPEN. Journal of parenteral and enteral nutrition 26 5 7488d60e-a91a-408e-94ac-dd717fe931cf Article (Published version) Restricted J Parenter Enteral Nutr - 2002 - Du.pdf 122620 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine Faculté de médecine / Section de médecine clinique / Département d'anesthésiologie, pharmacologie, soins intensifs et urgences

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Physical characteristics of total parenteral nutrition bags significantly affect the stability of vitamins C and B1: a controlled prospective study	JPEN. Journal of parenteral and enteral nutrition			2002	325	0

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Morch, Agnès