Effect of Intralipid,Amino Acids,Container,Temperature,and Duration of Storage on Vitamin Stability in Total Parenteral Nutrition Admixtures

Abstract

This study was designed to determine the stability of certain vitamins added to total parenteral nutrition (TPN) admixtures with or without Intralipid iv fat emulsion and with each of four amino acid solutions stored in either glass bottles or plastic bags at either ambient room (25°C) or refrigerator (5°C) temperature for a 48-hr period. Riboflavin and folacin were not affected by the experimental conditions. The presence of Intralipid resulted in higher levels of vitamin E due to Intralipid's inherent vitamin E content; no other experimental conditions affected vitamin E. Thiamin levels decreased in admixtures containing the amino acid solution C and stored at 25°C. Vitamin A levels were lower in admixtures stored in plastic but were maintained in admixtures containing Intralipid and stored in glass bottles at either temperature. Vitamin C levels were maintained in admixtures stored at 5°C for all experimental conditions. The greatest vitamin C losses occurred in admixtures containing amino acid solutions C or D stored in plastic bags, or containing D stored in glass bottles at 25°C. (Journal of Parenteral and Enteral Nutrition 12:478-483, 1988)

Get full access to this article

View all access options for this article.

References

Kirkland WD , Wells PA , Lund LJ : Compatibility of IV fat emulsion in total parenteral nutrition admixtures . JPEN 6:586A, 1982

Pamperl H. , Kleinberger G. : Morphologic changes of Intralipid 20% liposomes in all-in-one solutions during prolonged storage. Infusiontherapie 9:86-91, 1982

Amy S. , Muller R. , Orlansky A. , et al: Clinical use of an admixture of amino acids, dextrose and fat emulsion: Compatibility and stability. JPEN 6:586A, 1982

Epps DR , Knutsen CV , Kaminski MV , et al: Clinical results with total nutrient admixture for intravenous infusion. Clin Pharm 2:268-70, 1983

Chiou WL , Moorhatch P. : Interaction between vitamin A and plastic intravenous fluid bags. JAMA 223:328, 1973

Nedich RL : Vitamin A absorption from plastic bags. JAMA 224:1531-1532, 1973

Moorhatch P. , Chiou WL : Interactions between drugs and plastic IV fluid bags. I. Sorption studies on 17 drugs. Am J Hosp Pharm 31:72-78, 1974

Hartline JV , Zachman RD : Vitamin A delivery in TPN solution. Pediatrics 58:448-451, 1976

McKenna MC , Bieri JG : Loss of vitamin A from TPN solutions. Fed Proc 39:561, 1980

10.

Gillis J. , Jones G. , Pencharz P. : Delivery of vitamins A, D, and E in TPN solutions. JPEN 7:11-14, 1983

11.

Howard L. , Chu R. , Feman S. , et al: Vitamin deficiency from long-term TPN. Ann Int Med 93:576-577, 1980

12.

Van Zoeren-Grobben D. , Schriver J. , Van Den Berg H. , Berger HM : Human milk vitamin content after pasteurization, storage, or tube feeding. Arch Dis Child 62:161-165, 1987

13.

Neeld JB Jr , Pearson WN : Macro- and micromethods for the determination of serum vitamin A using trifluoracetic acid. J Nutr 26:454-462, 1963

14.

Manual for Nutrition Surveys, 2nd ed, Interdepartmental Committee on Nutrition for National Defense , eds. National Institutes of Health, Bethesda. MD, pp 117-121, 136-142, 1963

15.

Hansen LC , Warwich WJ : A fluorometric micromethod for serum tocopherol. Am J Clin Pathol 46:133-138, 1966

16.

Dunn RT , Foster LB : Radioassay of serum folate. Clin Chem 19:1101-1105, 1973

17.

Givas JK , Gutcho S. : pH dependence of the binding of folates to milk binder in radioassay of folates . Clin Chem 21:427-428, 1975

18.

Jessen D. , Hohlen M. , Tuccy J. : SPSS/ONLINE Document version 8.0. Northwestern University Computing Center Document #296, 1978

19.

Scheiner JM , Araujo MM , DeRitter E. : Thiamin destruction by sodium bisulfite in infusion solutions. Am J Hosp Pharm 38: 1911-1913, 1981

20.

Conners KA , Amidon GL , Kennon L. : Chemical stability of pharmaceuticals. John Wiley and Sons , New York, 1979, pp 318-326