The aluminum content of intravenous solutions in routine use in Turkey

Abstract

Aluminum (Al), an element with no known biological function, has been shown both clinically and experimentally to be toxic to bones, the central nervous system and liver. Aluminum is a contaminant of a number of large and small volume parenterals, most often given intravenously. Since the mid-1970's, reports have been frequently published about Al contamination of intravenous solutions from the United States and Europe. The purpose of this study is to determine the degree of aluminum contamination in total parenteral nutrition (TPN) solutions and other intravenous fluids in routine use in Turkey. Determination of concentration of Al in various solutions (solutions of amino acids, dextrose, lipid emulsions, human albumin, 0.9% sodium chloride (NaCl), potassium chloride (KCl), calcium, magnesium sulfate (MgSO4), vitamin, carnitine, etc.) was performed by inductively coupled argon plasma emisson spectrometry (ICP). We found a high degree of Al contamination in parenterals extending to 356 µg Al/L in amino acid solutions, 1112 µg Al/L in lipid emulsions, 380 µg Al/L dextroses, 2750 µg Al/L in human albumin, 4040 µg Al/L in calcium and 2200 µg Al/L in vitamin C solutions. These Al contents may be regarded as extremely high when compared to the FDA's (Food and Drug Administration) recommendation of setting an upper limit of 25 µg Al/L for all parenterals. Therefore, the amount of Al in TPN and other parenteral solutions used in Turkey should be urgently minimized.