December 3, 200618 yr We don't cover the TPN-bags at all. (Do manufacturers of TPN constituents have different recommendations, as to whether their products are light-sensitive?)
December 4, 200618 yr Author A number of researchers have demonstarted that covering TPN solutions would decrease peroxide load. We have just finnished a RCT in our institution and we had similar reults. We are updating our guidelines and we are searching for other institutions guidelines
December 4, 200618 yr Some water-soluble vitamins (e.g. riboflavin’s) that are mixed with TPN (we use vaminolac) need to be protected from light. If you don’t, riboflavin will be reduced quite rapidly.
December 4, 200618 yr Hmm, I will get in touch with our TPN group & the Pharmacy and see hear their opinion on why we don't cover the TPN.
December 8, 200618 yr Author Dear Stefan Lipids and multivitamines are particularliy involved in peroxides production on exposure to light. Using special bags or covering TPN solutions with alminum foil may be a good practice.
May 14, 200717 yr comment_553 We use dark opaque brown bags to cover TPN in our NICU. They help to protect mutliple additives from photo-oxidation. Jennifer Tucker RN HCMC Minneapolis, MN
August 17, 200717 yr comment_709 Yes, we use the amber plastic bags as well to cover the TPN. TPN arrives from Pharmacy in these bags, and once hung the amber bag is slipped over the TPN bag to keep it covered.
August 31, 200717 yr We have not been covering our TPN as fat soluble vitamins are not available in India. But such vitamins are known to produce peroxideson photooxidation. I will just like to ask how do You check for peroxides ? Is there a special test.
September 6, 200717 yr Author Please refer to the following articles: 1- Chessex P, Harrison A, Khashu M, Lavoie JC. In preterm neonates, is the risk of developing bronchopulmonary dysplasia influenced by the failure to protect total parenteral nutrition from exposure to ambient light? J Pediatr. 2007 Aug;151(2):213-4. 2: Khashu M, Harrison A, Lalari V, Gow A, Lavoie JC, Chessex P. Photoprotection of parenteral nutrition enhances advancement of minimal enteral nutrition in preterm infants. Semin Perinatol. 2006 Jun;30(3):139-45. 3: Lavoie JC, Rouleau T, Gagnon C, Chessex P. Photoprotection prevents TPN-induced lung procollagen mRNA in newborn guinea pigs. Free Radic Biol Med. 2002 Aug 15;33(4):512-20. 4: Chessex P, Laborie S, Lavoie JC, Rouleau T. Photoprotection of solutions of parenteral nutrition decreases the infused load as well as the urinary excretion of peroxides in premature infants. Semin Perinatol. 2001 Apr;25(2):55-9. Review. 5: Laborie S, Lavoie JC, Chessex P. Increased urinary peroxides in newborn infants receiving parenteral nutrition exposed to light. J Pediatr. 2000 May;136(5):628-32. 6: Baird LL. Protecting TPN and lipid infusions from light: reducing hydroperoxides in NICU patients. Neonatal Netw. 2001 Mar;20(2):17-22. Review. 7: Lavoie JC, Belanger S, Spalinger M, Chessex P. Admixture of a multivitamin preparation to parenteral nutrition: the major contributor to in vitro generation of peroxides. Pediatrics. 1997 Mar;99(3):E6.
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