The Effect of Light on Lipid Peroxidation in SMOFlipid Mixtures During Storage, Transportation and Administration

Intravenous lipid mixtures were a component of 2-in-1 parenteral nutrition (PN) and were administered separately from the dextrose and amino acids mixture. SMOFlipid, the most recent composite intravenous lipid emulsion, has seen frequent use in the past decade. The SMOFlipid mixtures were prepared by mixing SMOFlipid with water-soluble and lipid-soluble vitamins. The lipid peroxidation products have been associated with serious comorbidities in premature infants. The light-exposed SMOFlipid mixtures promoted lipid peroxidation, especially administered under phototherapy, thus, the SMOFlipid mixtures were recommended to protected from light during storage, transportation, and administration. The malondialdehyde (MDA) concentration level in SMOFlipid mixtures, as a marker for lipid peroxidation, was measured up to 24 hours during storage, transport, and administration with and without light protection in simulated conditions. The MDA in SMOFlipid mixtures was chemically derivatized and analyzed using high-performance liquid chromatography. The intact SMOFlipid was used as a control. The MDA level at 24 hours in all samples exposed to ambient light was higher, up to 3.9-fold than the MDA level at initial baselines. Whereas, all samples protected from light for 24 hours showed the MDA level slightly increased up to 2.4-fold. The MDA level observed in intact SMOFlipid was higher than SMOFlipid mixtures. The aluminum foil and fabric textiles, used as light protection materials, were comparable for light protection during 24-hour administration. However, using aluminum foil as light protection material during phototherapy for 24 hours, the MDA level was slightly higher than fabric textiles. Our findings indicated that SMOFlipid and SMOFlipid mixture for 2-in-1 PN should be completely protected from light during storage, transportation and administration. The fabric textile covering was introduced and considered due to its re-usable and light protective properties for PN in transport and administration under ambient light and phototherapy.