Such Díaz A, Sánchez Gil C, Gomis Muñoz P, Herreros de Tejada A
Servicio de Farmacia, Hospital Universitario 12 de Octubre, Madrid, España.
Nutr Hosp. 2009 Jan-Feb;24(1):1-9.
Some decades ago, several studies were published describing vitamins degradation in parenteral nutrition (PN) and their catalysis by oligoelements such as copper. Thus, the practice of administering oligoelements and vitamins every other day and adding them the same day of PN was implemented. Today, in many Spanish hospitals these recommendations are still being followed although currently different products, type of containers, and ways of administration are used. The purpose of this review is to determine whether combined administration of vitamins and oligoelements with PN is recommended and how many days they remain stable while refrigerated under the current conditions of preparation and administration of PN.
We have reviewed the articles on vitamins stability in PN published after 1990.
The results are controversial with vitamin A, although "all-in-one" administration and photo-protection remarkably decrease its degradation and there seems to be no difference between adding the vitamin before its administration and doing so previously. Vitamin E is stable with photo-protection for 3-7 days under refrigeration plus one additional day at room temperature if multilayered bags are used. Thiamine is stable if bisulfites-free amino acids solutions are used.
We conclude that vitamins and oligoelements may be administered together and PN be prepared before use if "all-in-one" photo-protected multilayered bags and bisulfite-free amino acids solutions are used.
几十年前,有几项研究发表,描述了肠外营养(PN)中维生素的降解情况以及铜等微量元素对其的催化作用。因此,实施了每隔一天给予微量元素和维生素,并在PN当天添加它们的做法。如今,在许多西班牙医院,尽管目前使用了不同的产品、容器类型和给药方式,但这些建议仍在遵循。本综述的目的是确定是否推荐将维生素和微量元素与PN联合给药,以及在当前PN的制备和给药条件下冷藏时它们能保持稳定多少天。
我们回顾了1990年后发表的关于PN中维生素稳定性的文章。
关于维生素A的结果存在争议,尽管“全合一”给药和光保护能显著降低其降解,并且在给药前添加维生素与提前添加似乎没有差异。如果使用多层袋,维生素E在冷藏条件下光保护3 - 7天稳定,在室温下再加一天稳定。如果使用不含亚硫酸盐的氨基酸溶液,硫胺素是稳定的。
我们得出结论,如果使用“全合一”光保护多层袋和不含亚硫酸盐的氨基酸溶液,可以将维生素和微量元素一起给药,并在使用前制备PN。