Laborie S, Lavoie J C, Pineault M, Chessex P
Department of Pediatrics and Pharmacy, and the Research Center of Hospital Ste-Justine, University of Montreal, Quebec, Canada.
JPEN J Parenter Enteral Nutr. 1999 Mar-Apr;23(2):104-8. doi: 10.1177/0148607199023002104.
Light exposure induces the generation of peroxides in solutions of total parenteral nutrition (TPN). Peroxide toxicity has been documented in cell, in tissue, and in isolated organs. To decrease the infused peroxide load and to protect the quality of the parenteral nutrients, we tested the photoprotective properties of different infusion sets.
Solutions of fat-free TPN and all-in-one total nutrient admixture (TNA) were run through sets of bags (clear and covered) and tubings (clear and colored: black, orange, and yellow) offering different levels of protection against light. Peroxide levels were determined by ferrous oxidation of xylenol orange, thiol functions by the 5,5,-dithiobis(2-nitrobenzoic acid) technique, and absorbance of tubings by spectroscopy.
Protection of only the bag had little effect on peroxide generation. In fat-free TPN solutions kept in covered bags, peroxide concentrations were 1.5 to 2 times higher when run through clear compared with colored tubings. When exposed to phototherapy or in the presence of lipids, peroxides were two to three times higher with the clear compared with the black tubing; meanwhile, orange and yellow tubings offered varying levels of protection related to their light-absorbing properties. Colored tubings offered a greater protection against the disappearance of thiol functions.
Covering bags and using orange and yellow tubings may be a practical solution to reduce infused peroxide loads from about 400 to 100 microM. This is especially relevant in patients with an immature or a compromised antioxidant capacity or when phototherapy or preparations of TNA are used.
光照会促使全胃肠外营养（TPN）溶液中过氧化物的生成。过氧化物毒性已在细胞、组织和离体器官中得到证实。为了减少输入的过氧化物负荷并保护肠外营养物质的质量，我们测试了不同输液装置的光保护特性。
将无脂TPN溶液和全合一全营养混合液（TNA）通过提供不同程度光保护的袋装（透明和有遮盖）和管道（透明和有色：黑色、橙色和黄色）。通过二甲酚橙的亚铁氧化法测定过氧化物水平，采用5,5'-二硫代双（2-硝基苯甲酸）技术测定硫醇功能，并通过光谱法测定管道的吸光度。
仅对袋子进行保护对过氧化物生成影响不大。在有遮盖袋子中保存的无脂TPN溶液中，与有色管道相比，通过透明管道输注时过氧化物浓度高1.5至2倍。当暴露于光疗或存在脂质时，与黑色管道相比，透明管道中的过氧化物高出两到三倍；同时，橙色和黄色管道根据其吸光特性提供不同程度的保护。有色管道对硫醇功能的消失提供了更好的保护。
遮盖袋子并使用橙色和黄色管道可能是一种切实可行的解决方案，可将输入的过氧化物负荷从约400微摩尔降至100微摩尔。这在抗氧化能力不成熟或受损的患者中，或在使用光疗或TNA制剂时尤为重要。
