Aluminum exposure in premature babies related to total parenteral nutrition and treatments

Abstract

This study aimed to measure aluminum contamination of parenteral nutrition(PN) solutions and aluminum contents of parenteral products given tonewborn infants for nutrition or treatment. In this study, the aluminumcontent of the first products used to prepare PN solutions for prematureneonates, of the final parenteral products prepared therefrom, and of theparenteral drugs frequently used in newborn units was measured using theinductively coupled plasma mass spectrometry. The aluminum contaminationof all parenteral nutritional products evaluated, except for one, was detectedto be over the recommended doses. Of all the first products analyzed withinthe scope of the study, trace-element preparation, preparation containingfat-soluble vitamins, 20% dextrose solution, calcium gluconate ampoule andsodium phosphate ampoule indicated high aluminum contamination. Thetotal aluminum content of the prepared final products was identified to be atleast 40% higher than the total aluminum content of the ingredients addedto the compound. Accordingly, the minimum amount of aluminum contentwas measured as 233 μg/kg/day in nutrition solutions prepared for a babyweighing 1,000 g. Contamination was detected in 9 of the 18 drugs evaluated.This study indicated that the rate of aluminum exposure of the prematurebabies receiving parental nutrition is still much higher than the safe dosesrecommended as 5 µg/kg/day by the FDA. Products with lower aluminumcontent should be preferred in the care of premature infants.