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Pediatric parenteral nutrition and hydroperoxide toxicity: evaluation of the effectiveness of photoprotection medical devices
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  • Fabien Nativel,
  • Pierre Nizet,
  • Nicolas Guillard,
  • Lionel Chabaud,
  • Kamel-Olivier Sellal,
  • Corinne Lejus-Bourdeau,
  • Laure Simon,
  • Dominique Navas,
  • Emmanuelle Olivier,
  • Johann Clouet,
  • Fabien Lindenberg
Fabien Nativel
Centre Hospitalier Universitaire de Nantes

Corresponding Author:[email protected]

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Pierre Nizet
Centre Hospitalier Universitaire de Nantes
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Nicolas Guillard
Centre Hospitalier Universitaire de Nantes
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Lionel Chabaud
Universite de Nantes UFR des Sciences Pharmaceutiques et Biologiques
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Kamel-Olivier Sellal
Centre Hospitalier Universitaire de Nantes
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Corinne Lejus-Bourdeau
Centre Hospitalier Universitaire de Nantes
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Laure Simon
Centre Hospitalier Universitaire de Nantes
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Dominique Navas
Centre Hospitalier Universitaire de Nantes
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Emmanuelle Olivier
Centre Hospitalier Universitaire de Nantes
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Johann Clouet
Centre Hospitalier Universitaire de Nantes
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Fabien Lindenberg
Centre Hospitalier Universitaire de Nantes
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Abstract

Exposure of parenteral nutrition (PN) to light induces hydroperoxides (HPO) formation whose toxicity, especially in pediatrics, is documented. In this context, we evaluated the efficacy of photoprotection medical devices used in our institution to protect PN from degradation after two different exposures to light. A mixed oil lipid emulsion (Smoflipid®) in standard or opaque syringes and a ternary PN mixture bags (Numetah®) with or without opaque overwrap were exposed for at least 420min to a xenon lamp. Samples of Smoflipid® in standard or opaque syringes were also exposed for 24h to conditions reproducing those of a neonatal intensive care unit. The use of opaque syringes for Smoflipid® administration or opaque overwraps for Numetah® administration reduced HPO formation by an average of 14% and 40%, respectively, compared to standard conditions after at least 420min to a xenon lamp. When Smoflipid® samples were administered with standard or opaque syringes and exposed to a phototherapy lamp, the fold-change in the HPO concentration increased, respectively, by 6.3 or 5.4 at 24h compared with syringes unexposed to phototherapy lamp. Although the observed differences were non-significant, it nonetheless appears prudent to use photoprotection of PN during administration, particularly in patients with immature or compromised antioxidant capacity.