1
|
Francke NM, Bunjes H. Influence of drug loading on the physical stability of phospholipid-stabilised colloidal lipid emulsions. Int J Pharm X 2020; 2:100060. [PMID: 33305256 PMCID: PMC7711285 DOI: 10.1016/j.ijpx.2020.100060] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
When poorly water-soluble drugs are formulated in colloidal lipid emulsions, adequate stability of the emulsion must be ensured. The aim of this work was to investigate different aspects related to drug loading in order to gain a better understanding on how drugs affect the stability of phospholipid-stabilised emulsions. To obtain information on emulsion stability, a rapid and reproduceable shaking test was developed. A passive loading approach was applied for drug loading of the commercially available nanoemulsion Lipofundin® MCT/LCT 10% with seven drugs of different charge and localisation tendency within the emulsion system. Localisation of drug molecules in the droplet interface did not generally lead to destabilisation of the emulsion, whereas the charge of the drug was of decisive importance. Aspects such as the drug concentration, its influence on the pH and the impact of zeta potential changes had an influence on emulsion stability as well. Certain destabilising effects of drugs could be counteracted by modification of the pH. Lipofundin® MCT/LCT 10%, passively loaded with propofol, was compared with two commercially available propofol preparations. No negative effect of the passive loading procedure could be detected.
Collapse
Affiliation(s)
- Nadine Monika Francke
- Technische Universität Braunschweig, Institut für Pharmazeutische Technologie und Biopharmazie, Mendelssohnstraße 1, 38106 Braunschweig, Germany
| | - Heike Bunjes
- Technische Universität Braunschweig, Institut für Pharmazeutische Technologie und Biopharmazie, Mendelssohnstraße 1, 38106 Braunschweig, Germany
- Zentrum für Pharmaverfahrenstechnik, Franz-Liszt-Straße 35A, 38106 Braunschweig, Germany
| |
Collapse
|
2
|
Stability of commercial parenteral lipid emulsions repacking to polypropylene syringes. PLoS One 2019; 14:e0214451. [PMID: 30970011 PMCID: PMC6457611 DOI: 10.1371/journal.pone.0214451] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 03/13/2019] [Indexed: 11/19/2022] Open
Abstract
To accommodate small fluid volumes, repackaging of intravenous lipid emulsions is frequently performed in hospitals providing parenteral nutrition to neonates and smaller pediatric patients. The physical stability of lipid commercial parenteral emulsions repacked and stored in polypropylene syringe up to 30 days at room temperature, refrigerator and 40°C was determined to establish options for extended storage. Lipid emulsions in the manufacturers’ original containers were used as references. Commercial lipid emulsions (20% of oil phase), ClinOleic, Intralipid, Smoflipid, Omegaven and Lipofindin LCT/MCT were repackaged under aseptic conditions in polypropylene syringes and stored at 4°C, 25°C and 40°C without light protection. Samples were assayed periodically over 30 days using validated, stability-indicating methods. Lipid emulsions in the manufacturers’ containers stored in the same conditions were as references. Analysis of variance showed differences in the physical parameters due to temperature (p<0.05) and study day (p<0.05) but not the type of the emulsion (p = 0.98). The parenteral lipid emulsions in polypropylene syringe exhibited identical (except Z-avarage at 40°C, t = 30 days) to original containers time-dependent behavior taking into account the mean globule size, pH, and zeta potential measurements. Size of oily droplets of all test conditions remained below the United States Pharmacopeia limits. The results allow safe repacking of commercial lipid emulsion in a syringe, which is a necessary condition for supplying parenteral nutrition using the two-in-one method for newborns. However, longer storage than 12 h of repacked emulsion needs microbiological studies.
Collapse
|
3
|
King HM, Cosslett AG, Thomas CP, Price-Davies R. A HPLC method to monitor the occurrence of lipid peroxidation in intravenous lipid emulsions used in parenteral nutrition using in-line UV and charged aerosol detection. Clin Nutr ESPEN 2018; 28:96-102. [PMID: 30390899 DOI: 10.1016/j.clnesp.2018.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Accepted: 09/11/2018] [Indexed: 11/25/2022]
Abstract
Parenteral Nutrition (PN) provides life sustaining support where gastrointestinal nutrition is inadequate due to disease or prematurity. Intravenous lipid emulsions (IVLEs) form a staple part of PN. Whilst the physical stability of IVLE's is relatively well known and quantified, chemical stability is an area where little testing has occurred. We report a new sensitive method for the monitoring of selected triglycerides present within two IVLEs and the detection and quantification of the peroxidation product 4-hydroxynonenal (HNE) using HPLC with in-line UV and charged aerosol detection (CAD). IVLEs used included the soy-bean oil based emulsion Intralipid® 20% and SMOFlipid® 20% (Fresenius Kabi UK), based on soy-bean, olive, fish oil and medium chain triglycerides. Assay validation gave R2 values of ≥0.99 for all selected triglyceride peaks and 4-hydroxynonenal. Inter and intra-day repeatability gave RSD values < 7.2% for CAD detection, achieving a precise and repeatable method. HNE was confirmed through internal standardisation of the HPLC method. Selected triglycerides were identified using ESI-MS with MicroTOF. This novel method permits the chemical stability of IVLEs to be quantified and monitored in respect to lipid peroxidation during storage prior to delivery to the patient, ensuring the optimal safety of IVLEs in a clinical setting.
Collapse
Affiliation(s)
- Helen M King
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, Wales, CF10 3NB, UK.
| | - Allan G Cosslett
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, Wales, CF10 3NB, UK
| | - Christopher P Thomas
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, Wales, CF10 3NB, UK
| | - Rebecca Price-Davies
- Cardiff School of Pharmacy and Pharmaceutical Sciences, Cardiff, Wales, CF10 3NB, UK
| |
Collapse
|
4
|
Driscoll DF, Ling PR, Bistrian BR. Physical Stability of 20% Lipid Injectable EmulsionsviaSimulated Syringe Infusion: Effects of GlassvsPlastic Product Packaging. JPEN J Parenter Enteral Nutr 2017; 31:148-53. [PMID: 17308256 DOI: 10.1177/0148607107031002148] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The United States Pharmacopeia (USP) has proposed large-globule-size limits to ensure the physical stability of lipid injectable emulsions, expressed as the percent fat >5 microm, or PFAT(5), not exceeding 0.05%. Visibly obvious phase separation as free oil has been shown to occur in some samples if PFAT(5) is >0.4%. We recently found that lipids, newly packaged in plastic (P), exceed the proposed USP limits and seem to produce less stable total nutrient admixtures compared with those made from conventional glass (G), which do meet proposed USP standards. We tested the possible stability differences between 20% lipid injectable emulsions in either P or G in a simulated neonatal syringe infusion study. METHODS Eighteen individual syringes were prepared from each 20% lipid injectable emulsion product (n = 36) and attached to a syringe pump set at an infusion rate of 0.5 mL/hour. The starting PFAT(5) levels were measured at time 0 and after 24 hours of infusion, using a laser-based light obscuration technique as described by the USP Chapter <729>. The data were assessed by a 2-way analysis of variance (ANOVA) with Container (G vs P) and Time as the independent variables and PFAT as the dependent variable. RESULTS At time 0, the starting PFAT(5) level for lipids packaged in G was 0.006% +/- 0.001% vs 0.162% +/- 0.026% for P, whereas at the end of the infusion they were 0.013% +/- 0.003% and 0.328% +/- 0.046%, respectively. Significant differences were noted overall between groups for Container, Time, and Container-Time interaction (all p < .001). Bonferroni tests showed significant differences in PFAT(5) levels between Containers at time 0 (T-0; p < .001) and T-0 vs T-24 for P-based lipids (p < .001), whereas no such differences were noted for Time for the G-based lipids. Similar results were noted for PFAT(10) levels. CONCLUSIONS We confirm that presently available lipid injectable emulsions packaged in newly introduced plastic containers exceed the proposed USP <729> PFAT(5) limits and subsequently become significantly less stable during a simulated syringe-based infusion. Although modest growth (p = NS) in large-diameter fat globules was observed for the glass-based lipids, they remained within proposed USP globule size limits throughout the study. Glass-based lipids seem to be a more stable dosage form and potentially a safer way to deliver lipids via syringe infusion to critically ill neonates.
Collapse
Affiliation(s)
- David F Driscoll
- Department of Medicine, Division of Clinical Nutrition and Nutrition/Infection Laboratory, B. I. Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts 02215, USA.
| | | | | |
Collapse
|
5
|
|
6
|
Fell GL, Cho BS, Pan A, Nose V, Anez-Bustillos L, Dao DT, Baker MA, Nandivada P, Gura KM, Puder M. A Comparison of Fish Oil Sources for Parenteral Lipid Emulsions in a Murine Model. JPEN J Parenter Enteral Nutr 2016; 41:181-187. [PMID: 26993989 DOI: 10.1177/0148607116640275] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Fat emulsions are important components of parenteral nutrition (PN). Fish oil (FO) emulsions reverse cholestasis in PN-associated liver disease. There are 2 FO monographs. One is "FO; rich in omega-3 fatty acids" (NFO). The other, "omega-3 acids," (PFO), is enriched in omega-3 fatty acids, particularly eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). The purpose of this study is to compare the effects of 20% NFO and PFO emulsions produced in the laboratory in a murine model. METHODS Emulsions were compounded containing different oils: soybean oil (SO), NFO, and two PFOs differing in percentage of fatty acids as triglycerides (PFO66 and PFO90). Chow-fed mice received saline, one of the above emulsions, or a commercial FO (OM) intravenously (2.4 g/kg/day) for 19 days. On day 19, animals were euthanized. Livers, spleens, and lungs were procured for histologic analysis. RESULTS OM, SO, NFO, and PFO90 were well-tolerated clinically. PFO66 resulted in tachypnea and lethargy for ~1 minute following injections. At euthanasia, PFO66 and PFO90 groups had organomegaly. Histologically, these groups had splenic and hepatic fat-laden macrophages, and lungs had scattered fat deposits. Other groups had normal organs. CONCLUSIONS PFO emulsions present an attractive possibility for improving inflammation in PN-dependent patients by concentrating anti-inflammatory EPA and DHA. However, 20% PFO emulsions were poorly tolerated and precipitated adverse end organ sequelae, suggesting that they may not be safe. Development of novel manufacturing methods may achieve safe 20% PFO parenteral emulsions, but by established formulation methods, these emulsions were clinically suboptimal despite meeting pharmacopeial standards.
Collapse
Affiliation(s)
- Gillian L Fell
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Bennet S Cho
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Amy Pan
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Vania Nose
- 2 Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Lorenzo Anez-Bustillos
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Duy T Dao
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Meredith A Baker
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Prathima Nandivada
- 3 Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Kathleen M Gura
- 4 Department of Pharmacy, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Mark Puder
- 1 Vascular Biology Program and Department of Surgery, Boston Children's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
7
|
Staven V, Wang S, Grønlie I, Tho I. Development and evaluation of a test program for Y-site compatibility testing of total parenteral nutrition and intravenous drugs. Nutr J 2016; 15:29. [PMID: 27000057 PMCID: PMC4802595 DOI: 10.1186/s12937-016-0149-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 03/17/2016] [Indexed: 11/24/2022] Open
Abstract
Background There is no standardized procedure or consensus to which tests should be performed to judge compatibility/incompatibility of intravenous drugs. The purpose of this study was to establish and evaluate a test program of methods suitable for detection of physical incompatibility in Y-site administration of total parenteral nutrition (TPN) and drugs. Methods Eight frequently used methods (dynamic light scattering, laser diffraction, light obscuration, turbidimetry, zeta potential, light microscopy, pH-measurements and visual examination using Tyndall beams), were scrutinized to elucidate strengths and weaknesses for compatibility testing. The responses of the methods were tested with samples containing precipitation of calcium phosphate and with heat destabilized TPN emulsions. A selection of drugs (acyclovir, ampicillin, ondansetron and paracetamol) was mixed with 3-in-1 TPN admixtures (Olimel® N5E, Kabiven® and SmofKabiven®) to assess compatibility (i.e. potential precipitates and emulsion stability). The obtained compatibility data was interpreted according to theory and compared to existing compatibility literature to further check the validity of the methods. Results Light obscuration together with turbidimetry, visual inspection and pH-measurements were able to capture signs of precipitations. For the analysis of emulsion stability, light obscuration and estimation of percent droplets above 5 μm (PFAT5) seemed to be the most sensitive method; however laser diffraction and monitoring changes in pH might be a useful support. Samples should always be compared to unmixed controls to reveal changes induced by the mixing. General acceptance criteria are difficult to define, although some limits are suggested based on current experience. The experimental compatibility data was supported by scattered reports in literature, further confirming the suitability of the test program. However, conflicting data are common, which complicates the comparison to existing literature. Conclusions Testing of these complex blends should be based on a combination of several methods and accompanied by theoretical considerations.
Collapse
Affiliation(s)
- Vigdis Staven
- Hospital Pharmacy of North Norway Trust, Tromsø, Norway.,Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Siri Wang
- Department for Medicinal Product Assessment, Norwegian Medicines Agency, Oslo, Norway
| | - Ingrid Grønlie
- Hospital Pharmacy, Haukeland University Hospital, Bergen, Norway.,Norwegian Medicines for Children Network, Bergen, Norway.,Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Ingunn Tho
- Department of Pharmacy, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway. .,School of Pharmacy, Faculty of Mathematics and Natural Sciences, University of Oslo, Oslo, Norway.
| |
Collapse
|
8
|
Bahri S, Jmour I, Maoudoud I, Sfar S, Corriol O. Enquête nationale sur la préparation des mélanges de nutrition parentérale en néonatologie dans les centres hospitaliers tunisiens. NUTR CLIN METAB 2015. [DOI: 10.1016/j.nupar.2015.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
9
|
Driscoll DF, Nicoli DF. Analytical Methods for Determining the Size (Distribution) in Parenteral Dispersions. NON-BIOLOGICAL COMPLEX DRUGS 2015. [DOI: 10.1007/978-3-319-16241-6_7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
10
|
Wei LJ, Yu HY, Chang WB, Lin CH, Chen YC, Wu JB. Effect of container on the physicochemical stability of propofol injectable emulsion after being diluted with 0.9% NaCl for intravenous infusion. J Food Drug Anal 2013. [DOI: 10.1016/j.jfda.2013.09.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
|
11
|
Lobo BW, da Veiga VF, Cabral LM, Michel RC, Volpato NM, de Sousa VP. Influence of the relative composition of trace elements and vitamins in physicochemical stability of total parenteral nutrition formulations for neonatal use. Nutr J 2012; 11:26. [PMID: 22510447 PMCID: PMC3411489 DOI: 10.1186/1475-2891-11-26] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2011] [Accepted: 04/17/2012] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The present study aimed to evaluate the influence of the relative composition of trace elements and vitamins in physicochemical stability of neonatal parenteral nutrition. MATERIAL AND METHODS Three formulations for neonatal administration were selected; the main variable was the presence of trace elements and vitamins. The analyses where carried out immediately after preparation and at 24 h, 48 h, 72 h and 7 days after preparation. Three methods were selected to determine globule size: light obscuration, dynamic light scattering and optical microscopy. Complementary evaluation including visual inspection, determination of pH and osmolarity, peroxide levels and measurements of zeta potential were also performed. RESULTS There was an observable alteration in color and phase separation in the PN stored at 25°C and 40°C. Neither globule size pattern, nor any other physicochemical characteristic evaluated appeared to be considerably altered in any of the analyzed formulations even after 7 days of storage at 5°C. Globule size in all the PN studied was consistent with the established limit, below 500 nm by DLS measurement, and PFAT5 was below 0.05% under all storage temperatures. CONCLUSION Concomitant presence of trace elements and vitamins in the same neonatal formulation did not alter the evaluated aspects of stability.
Collapse
Affiliation(s)
- Bianca W Lobo
- Departamento de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brasil
| | - Venício F da Veiga
- Instituto de Microbiologia Professor Paulo de Góes, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brasil
| | - Lúcio M Cabral
- Departamento de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brasil
| | - Ricardo C Michel
- Instituto de Macromoléculas Professora Eloisa Mano, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21945-970, Brasil
| | - Nádia M Volpato
- Faculdade de Farmácia, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, 90610-000, Brasil
| | - Valéria P de Sousa
- Departamento de Medicamentos, Faculdade de Farmácia, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, 21941-902, Brasil
| |
Collapse
|
12
|
Vanek VW, Seidner DL, Allen P, Bistrian B, Collier S, Gura K, Miles JM, Valentine CJ, Kochevar M. A.S.P.E.N. Position Paper. Nutr Clin Pract 2012; 27:150-92. [DOI: 10.1177/0884533612439896] [Citation(s) in RCA: 122] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Affiliation(s)
| | | | - Penny Allen
- Critical Care Systems, Exeter, New Hampshire
| | - Bruce Bistrian
- Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | | | | | | | | | - Marty Kochevar
- American Society for Parenteral and Enteral Nutrition, Silver Spring, Maryland
| | | | | |
Collapse
|
13
|
Driscoll DF, Silvestri AP, Bistrian BR. Stability of MCT/LCT-Based Total Nutrient Admixtures for Neonatal Use Over 30 Hours at Room Temperature. JPEN J Parenter Enteral Nutr 2010; 34:305-12. [DOI: 10.1177/0148607109338215] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- David F. Driscoll
- Nutrition/Infection Laboratory, Department of Medicine, Beth Israel Deaconess Medical Center (BIDMC), and Harvard Medical School, Boston, Massachusetts
| | | | - Bruce R. Bistrian
- Nutrition/Infection Laboratory, Department of Medicine, Beth Israel Deaconess Medical Center (BIDMC), and Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
14
|
Driscoll DF, Ling PR, Bistrian BR. Pharmacopeial compliance of fish oil-containing parenteral lipid emulsion mixtures: Globule size distribution (GSD) and fatty acid analyses. Int J Pharm 2009; 379:125-30. [DOI: 10.1016/j.ijpharm.2009.06.021] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2008] [Revised: 06/15/2009] [Accepted: 06/18/2009] [Indexed: 11/16/2022]
|
15
|
Driscoll DF, Thoma A, Franke R, Klütsch K, Nehne J, Bistrian BR. Lipid globule size in total nutrient admixtures prepared in three-chamber plastic bags. Am J Health Syst Pharm 2009; 66:649-56. [DOI: 10.2146/ajhp080164] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- David F. Driscoll
- Stable Solutions, LLC, Goleta, CA 93117; at the time of writing he was Senior Researcher, Nutrition/Infection Laboratory, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, and Assistant Professor of Medicine, Harvard Medical School (HMS), Boston
| | | | | | | | - Jörg Nehne
- Hospital Care, Strategic. Marketing for I.V. Therapeutic; and Jorg Nehne, PhD., is Director,. Hospital Care, Pilot Plant Pharma, B. Braun, Melsungen, Germany
| | - Bruce R. Bistrian
- Nutrition/Infection Laboratory, BIDMC, and Professor of Medicine, HMS
| |
Collapse
|
16
|
|
17
|
Driscoll DF, Ling PR, Andersson C, Bistrian BR. Hepatic Indicators of Oxidative Stress and Tissue Damage Accompanied by Systemic Inflammation in Rats Following a 24-Hour Infusion of an Unstable Lipid Emulsion Admixture. JPEN J Parenter Enteral Nutr 2009; 33:327-35. [DOI: 10.1177/0148607108327155] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
| | - Pei-Ra Ling
- From Harvard Medical School, Boston, Massachusetts
| | | | | |
Collapse
|
18
|
Driscoll DF. The pharmacopeial evolution of intralipid injectable emulsion in plastic containers: From a coarse to a fine dispersion. Int J Pharm 2009; 368:193-8. [DOI: 10.1016/j.ijpharm.2008.09.059] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2008] [Accepted: 09/29/2008] [Indexed: 10/21/2022]
|
19
|
Gallegos C, Partal P, Franco JM. Droplet-size distribution and stability of lipid injectable emulsions. Am J Health Syst Pharm 2009; 66:162-6. [DOI: 10.2146/ajhp080031] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Críspulo Gallegos
- Chemical Engineering Department, University of Huelva, Huelva, Spain
| | - Pedro Partal
- Chemical Engineering Department, University of Huelva, Huelva, Spain
| | - José M. Franco
- Chemical Engineering Department, University of Huelva, Huelva, Spain
| |
Collapse
|
20
|
Driscoll DF, Ling PR, Silvestri A, Bistrian B. Fine vs. coarse complete all-in-one admixture infusions over 96 hours in rats: Fat globule size and hepatic function. Clin Nutr 2008; 27:889-94. [DOI: 10.1016/j.clnu.2008.08.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2008] [Revised: 07/03/2008] [Accepted: 08/25/2008] [Indexed: 10/21/2022]
|
21
|
Gonyon T, Carter PW, Dahlem O, Denet AR, Owen H, Trouilly JL. Container effects on the physicochemical properties of parenteral lipid emulsions. Nutrition 2008; 24:1182-8. [DOI: 10.1016/j.nut.2008.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2008] [Revised: 05/16/2008] [Accepted: 06/03/2008] [Indexed: 10/21/2022]
|
22
|
Driscoll DF, Bistrian BR, Demmelmair H, Koletzko B. Pharmaceutical and clinical aspects of parenteral lipid emulsions in neonatology. Clin Nutr 2008; 27:497-503. [DOI: 10.1016/j.clnu.2008.05.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2007] [Revised: 04/22/2008] [Accepted: 05/12/2008] [Indexed: 11/29/2022]
|
23
|
Thomovsky EJ, Backus RC, Mann FA, Richmond CK, Wagner-Mann CC. Effects of temperature and handling conditions on lipid emulsion stability in veterinary parenteral nutrition admixtures during simulated intravenous administration. Am J Vet Res 2008; 69:652-8. [PMID: 18447797 DOI: 10.2460/ajvr.69.5.652] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine whether lipid particle coalescence develops in veterinary parenteral nutrition (PN) admixture preparations that are kept at room temperature (23 degrees C) for > 48 hours and whether that coalescence is prevented by admixture filtration, refrigeration, or agitation. SAMPLE POPULATION 15 bags of veterinary PN solutions. PROCEDURES Bags of a PN admixture preparation containing a lipid emulsion were suspended and maintained under different experimental conditions (3 bags/group) for 96 hours while admixtures were dispensed to simulate IV fluid administration (rate, 16 mL/h). Bags were kept static at 4 degrees C (refrigeration); kept at 23 degrees C (room temperature) and continuously agitated; kept at room temperature and agitated for 5 minutes every 4 hours; kept static at room temperature and filtered during delivery; or kept static at room temperature (control conditions). Admixture samples were collected at 0, 24, 48, 72, and 96 hours and examined via transmission electron microscopy to determine lipid particle diameters. At 96 hours, 2 samples were collected at a location distal to the filter from each bag in that group for bacterial culture. RESULTS Distribution of lipid particle size in the control preparations and experimentally treated preparations did not differ significantly. A visible oil layer developed in continuously agitated preparations by 72 hours. Bacterial cultures of filtered samples yielded no growth. CONCLUSIONS AND CLINICAL RELEVANCE Data indicated that the veterinary PN admixtures kept static at 23 degrees C are suitable for use for at least 48 hours. Manipulations of PN admixtures appear unnecessary to prolong lipid particle stability, and continuous agitation may hasten lipid breakdown.
Collapse
Affiliation(s)
- Elizabeth J Thomovsky
- Department of Small Animal Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
| | | | | | | | | |
Collapse
|
24
|
Martin CR, Dumas GJ, Shoaie C, Zheng Z, Mackinnon B, Al-Aweel I, Bistrian BR, Pursley DM, Driscoll DF. Incidence of hypertriglyceridemia in critically ill neonates receiving lipid injectable emulsions in glass versus plastic containers: a retrospective analysis. J Pediatr 2008; 152:232-6. [PMID: 18206695 DOI: 10.1016/j.jpeds.2007.06.038] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 06/11/2007] [Accepted: 06/21/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To evaluate plasma clearance of lipid injectable emulsions packaged in either glass or plastic containers in neonates from 2 7-month periods, 1 year apart. STUDY DESIGN Clinical records from June 1 to December 31, 2003 (glass [G] period) and the same months in 2004 (plastic [P] period) were assessed. Neonates who received lipid injectable emulsions were studied. Lipid container (glass vs plastic) was the independent variable. RESULTS Of the 197 patients studied, 122 (G, 50/81; P, 72/116) had evaluable triglyceride (TG) levels, for an overall rate of 62%. Only birth weight (G, 1.09 +/- 0.32 kg vs P, 1.23 +/- .45 kg) and birth length (G, 36.4 +/- 3.5 cm vs P, 37.9 +/- 3.5 cm) were significantly different between the 2 groups (P = .047 and .028, respectively). There were no differences in the day of life on which lipid injection was started, the lipid dose, or the timing of TG measurements. The incidence of hypertriglyceridemia was significantly higher in the P period (G, 3/50 vs P, 19/72; P = .004). CONCLUSIONS Administration of the same lipid formulation in plastic bags compared with glass containers is associated with higher rates of hypertriglyceridemia. The poorer clearance of lipids could be due to a higher proportion of large-diameter fat globules in plastic bags compared with those in glass containers.
Collapse
Affiliation(s)
- Camilia R Martin
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | | | | | | | | | | | | | | | | |
Collapse
|