Shielding Parenteral Nutrition Solutions From Light: A Randomized Controlled Trial.
INTRODUCTION
Oxidant stress is implicated in the pathogenesis of bronchopulmonary dysplasia (BPD). Light induces peroxide generation in parenteral nutrition (PN) solutions, creating an oxidant stress. Shielding PN from light decreases its peroxide content, which has nutrition and biochemical benefits in animals and humans. This study aims at determining whether full light protection of PN decreases the rate of bronchopulmonary dysplasia and/or death in very low-birth-weight infants.


METHODS
Multicenter randomized controlled trial of photoprotection, using amber bags and tubing initiated during compounding of PN and maintained throughout infusion in the light-protected (LP) group. The control group (light exposed [LE]) received PN exposed to ambient light. Depending on centers, lipids were infused either separately or as all-in-one PN.


RESULTS
In total, 590 infants born <30 weeks gestational age were included. At randomization, LE and LP groups did not differ clinically except for maximal FiO2 before 12 hours. The rate of BPD/death was not different between groups at 28 days (77% LP vs 72% LE, P = .16) or at 36 weeks corrected age (30% LP vs 27% LE, P = .55). Multivariate analysis showed no significant effect of photoprotection on BPD and/or death. The rate of BPD/death was significantly lower (odds ratio, 0.54; 95% confidence interval, 0.32-0.93; P = .02) in infants receiving all-in-one PN vs those who received lipids separately.


CONCLUSION
This study did not show significant beneficial effects of photoprotection. Since the decreased rate of BPD/death found with all-in-one PN relates to a center-dependent variable, this warrants further investigation.
['Laborie|Sophie|S|', 'Denis|Angélique|A|', 'Dassieu|Gilles|G|', 'Bedu|Antoine|A|', 'Tourneux|Pierre|P|', 'Pinquier|Didier|D|', 'Kermorvant|Elsa|E|', 'Millet|Véronique|V|', 'Klosowski|Serge|S|', 'Patural|Hugues|H|', 'Clamadieu|Catherine|C|', 'Brunhes|Anne|A|', 'Walther|Marie|M|', 'Jaisson-Hot|Isabelle|I|', 'Mandy|Bruno|B|', 'Claris|Olivier|O|']
D001997:Bronchopulmonary Dysplasia D005260:Female D006801:Humans D007231:Infant, Newborn D019102:Infant, Very Low Birth Weight D007363:Intensive Care Units, Neonatal D008027:Light D008297:Male D015999:Multivariate Analysis D018384:Oxidative Stress D057947:Parenteral Nutrition Solutions D010545:Peroxides D011446:Prospective Studies D011835:Radiation Protection D016896:Treatment Outcome
parenteral nutrition bronchopulmonary dysplasia peroxides preterm infant very low birth weight