Stability of N-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of N,N-Diacetylcystine (DAC) Formation.

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Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_B3A77814E178
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Stability of N-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of N,N-Diacetylcystine (DAC) Formation.
Journal
Nutrients
Author(s)
Sommer I., Schwebel H., Adamo V., Bonnabry P., Bouchoud L., Sadeghipour F.
ISSN
2072-6643 (Electronic)
ISSN-L
2072-6643
Publication state
Published
Issued date
21/06/2020
Peer-reviewed
Oui
Volume
12
Number
6
Pages
1849
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
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 N-acetylcysteine (NAC) is easily converted into bioavailable cysteine. Its dimer N,N-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.
Keywords
Acetylcysteine/administration & dosage, Acetylcysteine/metabolism, Amino Acids/administration & dosage, Amino Acids/metabolism, Biological Availability, Cysteine/administration & dosage, Cysteine/metabolism, Cystine/analogs & derivatives, Cystine/metabolism, Drug Industry, Drug Stability, Drug Storage, Humans, Infant Nutritional Physiological Phenomena, Infant, Newborn, Infant, Premature, Nutritional Requirements, Oxidation-Reduction, Oxygen, Parenteral Nutrition, Parenteral Nutrition Solutions/chemistry, N,N-diacetylcystine, N-acetylcysteine, amino acids, cysteine, parenteral nutrition, pediatrics
Pubmed
Web of science
Open Access
Yes
Create date
03/07/2020 17:58
Last modification date
08/08/2024 6:39
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