Recommendations for photoprotection of parenteral nutrition for premature infants: An ASPEN position paper.

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Tytuł:: Recommendations for photoprotection of parenteral nutrition for premature infants: An ASPEN position paper.
Autorzy:: Robinson DT; Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Ayers P; Clinical Pharmacy Services, Department of Pharmacy, Baptist Medical Center, Jackson, Mississippi, USA.
Fleming B; Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois, USA.
Gura KM; Department of Pharmacy, Boston Children's Hospital, Boston, Massachusetts, USA.; Harvard Medical School, Boston, Massachusetts, USA.
Gutsul L; Central Admixture Pharmacy Services, Inc, Chicago, Illinois, USA.
Michalski A; Patient Food and Nutrition Services, Michigan Medicine, Ann Arbor, Michigan, USA.
Holcombe B; American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland, USA.
Sacks GS; Fresenius Kabi USA, LLC, Lake Zurich, Illinois, USA.; Auburn University Harrison School of Pharmacy, Auburn, Alabama, USA.
Źródło:: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2021 Oct; Vol. 36 (5), pp. 927-941. Date of Electronic Publication: 2021 Sep 01.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: 2018- : [Hoboken, NJ] : Wiley
Original Publication: [Baltimore, Md. : Williams & Wilkins, c1986-
MeSH Terms:: Bronchopulmonary Dysplasia*
Infant, Premature, Diseases*
Child ; Enteral Nutrition ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Parenteral Nutrition ; United States
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Contributed Indexing:: Keywords: intravenous fat emulsion; lipid injectable emulsions; oxidative stress; parenteral nutrition; patient safety; photoprotection; premature infants
Entry Date(s):: Date Created: 20210902 Date Completed: 20210929 Latest Revision: 20210929
Update Code:: 20240105
DOI:: 10.1002/ncp.10747
PMID:: 34472142
: Czasopismo naukowe

Although crucial in improving health outcomes in the preterm infants, parenteral nutrition (PN) is not without risk, especially if handled improperly. A growing body of evidence suggests that components of PN admixtures, including lipid injectable emulsions (ILEs), are susceptible to degradation, including oxidation when exposed to light (ie, photo-oxidation), resulting in the production of reactive oxygen species. Infants, especially those born preterm, are considered more susceptible to consequences of oxidative stress than children and adults. Oxidative stress is associated with bronchopulmonary dysplasia, retinopathy of prematurity, necrotizing enterocolitis, and intestinal failure-associated liver disease. The American Society for Parenteral and Enteral Nutrition (ASPEN) assembled a working group to provide recommendations on clinical practice surrounding photoprotection of PN.This Position Paper reviews the scientific literature on the formation of quantifiable peroxides and other degradation products when PN admixtures and ILEs are exposed to light and reports adverse clinical outcomes in premature infants exposed to PN. Recommendations for photoprotection of PN admixtures and ILEs are provided, as well as the challenges in achieving complete photoprotection with the equipment, supplies, and materials currently available in the US. ASPEN and the authors understand that the full implementation of complete photoprotection may not currently be feasible given current product availability; recommendations provided in this paper serve to represent the goal to which to strive as well as to highlight the importance of product availability to achieve these practices. This paper has been approved by the ASPEN Board of Directors.
(© 2021 American Society for Parenteral and Enteral Nutrition.)

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