Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation
The ESPGHAN/ESPEN/ESPR-Guidelines on pediatric parenteral nutrition (PPN) recommend the administration of the semiessential amino acid (AA) cysteine to preterm neonates due to their biochemical immaturity resulting in an inability to sufficiently synthetize endogenous cysteine. The soluble precursor...
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doaj-b521be76757c41628033081d3f0f38f62020-11-25T02:59:12ZengMDPI AGNutrients2072-66432020-06-01121849184910.3390/nu12061849Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) FormationIsabelle Sommer0Hervé Schwebel1Vincent Adamo2Pascal Bonnabry3Lucie Bouchoud4Farshid Sadeghipour5Department of Pharmacy, University Hospital of Lausanne, 1011 Lausanne, SwitzerlandB. Braun Medical AG, 1023 Crissier, SwitzerlandB. Braun Medical AG, 1023 Crissier, SwitzerlandInstitute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, 1211 Geneva, SwitzerlandDepartment of Pharmacy, Geneva University Hospitals, 1205 Geneva, SwitzerlandDepartment of Pharmacy, University Hospital of Lausanne, 1011 Lausanne, SwitzerlandThe ESPGHAN/ESPEN/ESPR-Guidelines on pediatric parenteral nutrition (PPN) recommend the administration of the semiessential amino acid (AA) cysteine to preterm neonates due to their biochemical immaturity resulting in an inability to sufficiently synthetize endogenous cysteine. The soluble precursor <i>N</i>-acetylcysteine (NAC) is easily converted into bioavailable cysteine. Its dimer <i>N</i>,<i>N</i>-diacetylcystine (DAC) is almost unconvertable to cysteine when given intravenously resulting in a diminished bioavailability of cysteine. This study aims to understand the triggers and oxidation process of NAC to DAC to evaluate possibilities of reducing DAC formation in standardized PPN. Therefore, different air volumes (21% O<sub>2</sub>) were injected into the AA compartment of a standardized dual-chamber PPN. O<sub>2</sub> concentrations were measured in the AA solution and the headspaces of the primary and secondary packaging. NAC and DAC concentrations were analyzed simultaneously. The analysis showed that O<sub>2</sub> is principally delivered from the primary headspace. NAC oxidation exclusively delivers DAC, depending on the O<sub>2</sub> amount in the solution and the headspaces. The reaction of NAC to DAC being containable by limiting the O<sub>2</sub> concentration, the primary headspace must be minimized during manufacturing, and oxygen absorbers must be added into the secondary packaging for a long-term storage of semipermeable containers.https://www.mdpi.com/2072-6643/12/6/1849parenteral nutritionpediatricsamino acidscysteine<i>N</i>-acetylcysteine<i>N</i>,<i>N</i>-diacetylcystine |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Isabelle Sommer Hervé Schwebel Vincent Adamo Pascal Bonnabry Lucie Bouchoud Farshid Sadeghipour |
spellingShingle |
Isabelle Sommer Hervé Schwebel Vincent Adamo Pascal Bonnabry Lucie Bouchoud Farshid Sadeghipour Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation Nutrients parenteral nutrition pediatrics amino acids cysteine <i>N</i>-acetylcysteine <i>N</i>,<i>N</i>-diacetylcystine |
author_facet |
Isabelle Sommer Hervé Schwebel Vincent Adamo Pascal Bonnabry Lucie Bouchoud Farshid Sadeghipour |
author_sort |
Isabelle Sommer |
title |
Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation |
title_short |
Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation |
title_full |
Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation |
title_fullStr |
Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation |
title_full_unstemmed |
Stability of <i>N</i>-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of <i>N</i>,<i>N</i>-Diacetylcystine (DAC) Formation |
title_sort |
stability of <i>n</i>-acetylcysteine (nac) in standardized pediatric parenteral nutrition and evaluation of <i>n</i>,<i>n</i>-diacetylcystine (dac) formation |
publisher |
MDPI AG |
series |
Nutrients |
issn |
2072-6643 |
publishDate |
2020-06-01 |
description |
The ESPGHAN/ESPEN/ESPR-Guidelines on pediatric parenteral nutrition (PPN) recommend the administration of the semiessential amino acid (AA) cysteine to preterm neonates due to their biochemical immaturity resulting in an inability to sufficiently synthetize endogenous cysteine. The soluble precursor <i>N</i>-acetylcysteine (NAC) is easily converted into bioavailable cysteine. Its dimer <i>N</i>,<i>N</i>-diacetylcystine (DAC) is almost unconvertable to cysteine when given intravenously resulting in a diminished bioavailability of cysteine. This study aims to understand the triggers and oxidation process of NAC to DAC to evaluate possibilities of reducing DAC formation in standardized PPN. Therefore, different air volumes (21% O<sub>2</sub>) were injected into the AA compartment of a standardized dual-chamber PPN. O<sub>2</sub> concentrations were measured in the AA solution and the headspaces of the primary and secondary packaging. NAC and DAC concentrations were analyzed simultaneously. The analysis showed that O<sub>2</sub> is principally delivered from the primary headspace. NAC oxidation exclusively delivers DAC, depending on the O<sub>2</sub> amount in the solution and the headspaces. The reaction of NAC to DAC being containable by limiting the O<sub>2</sub> concentration, the primary headspace must be minimized during manufacturing, and oxygen absorbers must be added into the secondary packaging for a long-term storage of semipermeable containers. |
topic |
parenteral nutrition pediatrics amino acids cysteine <i>N</i>-acetylcysteine <i>N</i>,<i>N</i>-diacetylcystine |
url |
https://www.mdpi.com/2072-6643/12/6/1849 |
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