RT Journal Article
SR Electronic
T1 Incompatibility of trace element copper with amino acids in paediatric parenteral nutrition
JF European Journal of Hospital Pharmacy
JO Eur J Hosp Pharm
FD British Medical Journal Publishing Group
SP 304
OP 305
DO 10.1136/ejhpharm-2015-000666
VO 22
IS 5
A1 L M Hanff
A1 J J M van Westerop
A1 B C P Koch
A1 B A E de Koning
YR 2015
UL http://ejhp.bmj.com/content/22/5/304.abstract
AB Case description The multi-trace-element preparation in the home total parenteral nutrition (TPN) of three infants with intestinal failure was changed. Subsequenty, shortly after TPN administration was started, discolouration caused by precipitation in the in-line filter was seen. Using scanning electron microscopy in combination with X-ray microanalysis (SEM/XRMA), the precipitate was found to contain copper, sulphur and nitrogen indicating a complex of copper with amino acids. The problem was resolved when the multi-trace-element preparation was replaced with a preparation containing less copper.Conclusions We conclude that the formation of a complex of copper from the multi-trace-element preparation with amino acids from the paediatric amino acid solution, may cause precipitation in paediatric home TPN solutions.