Contribution of the raw material to the aluminum contamination in parenterals

Bohrer, Denise; Nascimento, P. Do; Binotto, Regina; Becker, Emilene M.; Garcia, Solange Cristina

doi:10.1177/0148607102026006382

Cited by 50 publications

(33 citation statements)

References 15 publications

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“…In the most recent (2001) American investigation, Buchman et al also reported considerably higher values (1À8 lM/L) than in our coconuts and thus higher than the FDA's recommendations [26]. Likewise, Bohrer et al in a study from Brazil in 2002 also reported values between 0.3 lM/L and 300 lM/L, with almost all amino acid solutions being in excess of the FDA recommendation [27]. Our GCW is thus healthier than most commercial solutions.…”

Section: Minor Elements (Lm/l)supporting

confidence: 50%

Green coconut water for intravenous use: Trace and minor element content

Petroianu

Kosanović

Shehatta

et al. 2004

J Trace Elements Exper Med

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Green coconut water (GCW; liquid endosperm) is sterile and has been used in the past in remote locations and/or during armed conflicts as a short-term intravenous hydration fluid. It is also conceivable to use GCW for total parenteral nutrition (TPN) under similar circumstances. Patients on TPN need elemental supplementation. Although data on the major elements (calcium, magnesium, potassium, sodium, and phosphorus) found in GCW are abundant, very limited information concerning trace and minor element content in GCW is available. The purpose of this study was to determine trace and minor element content in GCW. Major elements were arbitrarily defined as those with a GCW concentration in the mM range, as opposed to minor ones in the lM range and trace elements in the nM range. The values determined show the great variability typical for samples of plant origin. Under TPN conditions, GCW (1,000 mL/day) would be able to provide adequate supplementation of manganese (12 ± 5 lmol/L) and possibly zinc (6 ± 1 lmol/L) but not chromium (not detected, i.e., less than 9 nM/L) and copper (105 ± 100 nM/L). With respect to elements usually considered nonessential or even toxic, GCW compares favorably with commonly used TPN solutions, most notably for aluminium content (740 ± 360 nM/L) and cadmium (7 ± 4 nM/L). The levels of lead (150 ± 67 nmol/L) and barium (600 ± 300 nmol/L) were similar to those typically found in commercial TPN solutions. Those of strontium (8 ± 4 lmol/L) are higher but unlikely to be harmful. In conclusion, although GCW is not completely equivalent to high-tech (and high-cost) TPN solutions with trace element supplements, it still may provide sufficient support of at least some of the trace elements if used as a substitute. The GCW investigated by us is, at least, not toxic. However, our results for several trace elements are much lower than values previously reported in the literature, especially in coconuts from ''polluted'' areas. GCW from polluted soil might be easily toxic if used intravenously.

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Section: Minor Elements (Lm/l)supporting

confidence: 50%

Green coconut water for intravenous use: Trace and minor element content

Petroianu

Kosanović

Shehatta

et al. 2004

J Trace Elements Exper Med

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“…Aluminumcontaining casein hydrolysates, used as protein components of TPN, were associated with patchy osteomalacia [42]. Casein is no longer used, but the possibility of aluminum overloading continues to be a concern [43,44]. Excessive vitamin D can also be deleterious to bone metabolism by suppressing PTH secretion and stimulating bone resorption, with a potential benefit when the supplement is discontinued [45,46].…”

Section: Bone Diseasementioning

confidence: 99%

Metabolic and catheter complications of parenteral nutrition

Ghabril

Aranda-Michel

Scolapio

2004

Curr Gastroenterol Rep

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Since its introduction in the 1960s, total parenteral nutrition (TPN) has played a vital role in improving clinical outcomes for patients with acute and chronic illnesses. The evolution of TPN solutions and vascular access techniques, combined with an increased awareness and better understanding of the physiology of TPN, have improved the safety of this therapy. Nevertheless, complications are not uncommon and can be life threatening. This article provides an updated review on the metabolic and catheter complications associated with TPN.

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“…This exposure may occur by dietary intake through feed or water [2,3] as well as through drugs, parenteral nutrition [4,5], and hemodialysis solutions [6].…”

Section: Introductionmentioning

confidence: 99%

“…Chemicals such as solutions for parenteral nutrition may have Al [4,5,26] and Si [27] contamination, especially if there is an affinity between the components and Al and/or Si [28]. The volume given to a patient in total parenteral nutrition (TPN) may reach 3000 mL per day, depending on the body weight.…”

Section: Introductionmentioning

confidence: 99%

Silicon Reverses Lipid Peroxidation but not Acetylcholinesterase Activity Induced by Long-Term Exposure to Low Aluminum Levels in Rat Brain Regions

Noremberg

Bohrer

Schetinger

et al. 2015

Biol Trace Elem Res

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Aluminum (Al) is the most widely distributed metal in the environment and is extensively used in daily life leading to easy exposure to human beings. Besides not having a recognized physiological role, Al may produce adverse effects through the interaction with the cholinergic system contributing to oxidative stress. The present study evaluated, in similar conditions of parenteral nutrition, whether the reaction of silicon (SiO2) with Al(3+) to form hydroxyaluminosilicates (HAS) reduces its bioavailability and toxicity through intraperitoneal administrations of 0.5 mg Al/kg/day and/or 2 mg Si/kg/day in Wistar rats. Al and Si concentrations were determined in rat brain tissue and serum. Acetylcholinesterase (AChE) activity and lipid peroxidation (LPO) were analyzed in the cerebellum, cortex, hippocampus, striatum, hypothalamus, and blood. An increase in the Al concentration was verified in the Al + Si group in the brain. All the groups demonstrated enhanced Si compared to the control animals. Al(3+) increased LPO measured by thiobarbituric acid reactive substances (TBARS) in cerebellum and hippocampus, whereas SiO2 reduced it when compared with the control group. An increase of AChE activity was observed in the Al-treated group in the cerebellum whereas a decrease of this enzyme activity was observed in the cortex and hippocampus in the Al and Al + Si groups. Al and Si concentrations increased in rat serum; however, no effect was observed in blood TBARS levels and AChE activity. SiO2 showed a protective effect in the hippocampus and cerebellum against cellular damage caused by Al(3+)-induced lipid peroxidation. Thus, SiO2 may be considered an important protector in LPO induced by Al(3+).

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Contribution of the raw material to the aluminum contamination in parenterals

Cited by 50 publications

References 15 publications

Green coconut water for intravenous use: Trace and minor element content

Green coconut water for intravenous use: Trace and minor element content

Metabolic and catheter complications of parenteral nutrition

Silicon Reverses Lipid Peroxidation but not Acetylcholinesterase Activity Induced by Long-Term Exposure to Low Aluminum Levels in Rat Brain Regions

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