Clinical and nutritional impacts of removing bisulfite from neonatal parenteral nutrition

There is a general willingness to eliminate sulfites from the diet because of adverse reactions. Because little is known about the biological effects of these antioxidants in vivo, we compared clinical and nutritional parameters in newborn infants receiving two parenteral amino acid solutions containing either 300 mg/dl or no metabisulfite. The primary objective was to verify whether decreasing the sulfur content of parenteral nutrition would diminish the calciuria of newborn infants. In a crossover design, 18 newborn infants received two regimens differing only in their metabisulfite content. Nitrogen and mineral balances; clinical parameters such as mean heart and respiratory rates, body temperature, and transcutaneous PO2 and PCO2 (n = 7); and energy expenditure were similar in both regimens. Withdrawing bisulfites from the diet did not change calciuria, put an extra burden on the infant's metabolic adaptation, or cause short-term clinical repercussions.