Huston Robert K, Heisel Carl F, Vermillion Benjamin R, Christensen J Mark, Minc Leah
1 Northwest Newborn Specialists, PC, and Pediatrix Medical Group, Portland, Oregon, USA.
2 Neonatal Pharmacy, Randall Children's Hospital at Legacy Emanuel, Portland, Oregon, USA.
Nutr Clin Pract. 2017 Apr;32(2):266-270. doi: 10.1177/0884533616668789. Epub 2016 Sep 28.
Calcium chloride (CaCl) has been the only calcium additive available in the United States that has a low aluminum (Al) content. Calcium gluconate in glass vials (CaGluc-Gl) has a high Al content while calcium gluconate in plastic vials (CaGluc-Pl) has a low Al content. The purpose of this study was to measure Al concentrations in neonatal parenteral nutrition (PN) solutions prepared using various calcium additives.
Samples of solutions compounded with CaCl or CaGluc-Gl and sodium phosphate (NaPhos) as well as CaGluc-Pl and sodium glycerophosphate (NaGP) with and without cysteine were analyzed for Al content. Samples of the cysteine and calcium gluconate additives were also sent for analysis.
Solutions containing CaCl and CaGlu-Pl had mean Al concentrations of 1.2-2.3 mcg/dL, while those with CaGlu-Gl had mean concentrations of 14.6-15.1 mcg/dL. Solutions made with NaGP were low in Al content. The measured Al content of 2 lots of the cysteine additive were 168 ± 23 mcg/L and 126 ± 5 mcg/L. The Al concentration equalled 2730 ± 20 mcg/L for the CaGlu-Gl additive and 310 ± 80 mcg/L for the CaGlu-Pl additive.
The study indicates that solutions containing CaCl or CaGluc-Pl and NaPhos or NaGP are low in Al content. Using these options for calcium and phosphate additives can limit aluminum intake from neonatal PN to levels within the Food and Drug Administration guideline of ≤5 mcg/kg/d.
氯化钙（CaCl）一直是美国唯一一种铝（Al）含量低的钙添加剂。玻璃瓶装葡萄糖酸钙（CaGluc-Gl）的铝含量高，而塑料瓶装葡萄糖酸钙（CaGluc-Pl）的铝含量低。本研究的目的是测量使用各种钙添加剂配制的新生儿肠外营养（PN）溶液中的铝浓度。
分析了分别用CaCl或CaGluc-Gl与磷酸钠（NaPhos）以及CaGluc-Pl与甘油磷酸钠（NaGP）配制的溶液样品，这些样品有的添加了半胱氨酸，有的未添加半胱氨酸，以测定铝含量。还将半胱氨酸和葡萄糖酸钙添加剂的样品送去分析。
含CaCl和CaGlu-Pl的溶液平均铝浓度为1.2 - 2.3 mcg/dL，而含CaGlu-Gl的溶液平均浓度为14.6 - 15.1 mcg/dL。用NaGP配制的溶液铝含量低。两批半胱氨酸添加剂的实测铝含量分别为168±23 mcg/L和126±5 mcg/L。CaGlu-Gl添加剂的铝浓度为2730±20 mcg/L，CaGlu-Pl添加剂的铝浓度为310±80 mcg/L。
该研究表明，含CaCl或CaGluc-Pl以及NaPhos或NaGP的溶液铝含量低。使用这些钙和磷添加剂选项可将新生儿PN中的铝摄入量限制在食品药品监督管理局规定的≤5 mcg/kg/d的水平内。
