Assessment of trace element compatibility in total parenteral nutrition infusions

Abstract

The application of X-ray energy dispersive spectroscopy to detect elements collected from TPN mixtures on membrane filters has been investigated. Many simple total parenteral nutrition mixtures prepared aseptically in large bags can be stored for extended periods. Trace elements are normally excluded from such bags, because not enough is known about their long-term stability and compatibility in total parenteral nutrition mixtures. Assessing the compatibility of many trace elements by conventional methods that rely on detecting concentration changes is extremely difficult. Analysis of precipitates from total parenteral nutrition mixtures confirmed that the proposed method was capable of identifying a number of elements from the mixture in complex precipitates, including calcium, phosphorus, iron, copper and selenium.

In Vitro Assessment of Interaction Between Amino Acids and Copper in Neonatal Parenteral Nutrition

“…These different elements confirm our main hypothesis of a specific interaction between AA and TE, which is in accordance with previous studies 12 . ‐ 19 It has been hypothesized that the precipitate was copper cysteinate, formed from a chemical reaction between copper ions and cysteine. Further investigations are needed to determine the mechanism of precipitate formation and to exclude the possibility of copper sulfide formation 15 .…”

“…Previous studies have indicated that certain trace elements (TEs) may interact with other nutrients, leading to precipitation formation 12 . ‐ 19 TEs could react with proteins through redox reactions to form high‐affinity complexes. Among all the amino acids (AAs), mainly sulfur amino acids (cysteine and methionine) are affected by reactions with TEs; among the TEs, mainly zinc, copper, iron, and selenium are concerned 17 .…”

“…Among all the amino acids (AAs), mainly sulfur amino acids (cysteine and methionine) are affected by reactions with TEs; among the TEs, mainly zinc, copper, iron, and selenium are concerned 17 . ‐ 19 Precipitation was most commonly caused by the formation of iron phosphate salts or copper cysteinate in cysteine‐containing AA infusions 17 . ‐ 19 Another possibility is the formation of copper sulfide resulting from a reaction between copper and hydrogen sulfide because of a degradation of cysteine during the thermal sterilization process 15 …”

“…‐ 19 Precipitation was most commonly caused by the formation of iron phosphate salts or copper cysteinate in cysteine‐containing AA infusions 17 . ‐ 19 Another possibility is the formation of copper sulfide resulting from a reaction between copper and hydrogen sulfide because of a degradation of cysteine during the thermal sterilization process 15 …”

Nanomedicine: a new paradigm to overcome drug incompatibilities

“…[30][31][32] Oxidation of ascorbic acid, a water-soluble vitamin, is the most common and important reaction that has been widely investigated, and the role of some bivalent ions as catalysts, especially copper, has been established. [33,34] Allwood showed that vitamin A is more susceptible to photodegradation when exposed to wavelengths less than 400 nm, with maximum degradation occurring between 330 and 350 nm. Such wavelengths are more commonly found in natural daylight.…”