The Effects of Total Parenteral Nutrition on Plasma Aluminum Levels in Premature

Objectives: Aluminum accumulates in the body, disrupts mental development, affects bone mineral structure and causes cholestasis in the liver. Aimed to investigate parenteral nutrition and aluminum transmission in preterm infants.
Methods: Our study was designed as a single-center prospective study. And 45 babies were included during pregnancy weeks ≤32 and/or under 1500 grams. Cord blood samples were taken at birth from all infants. And blood levels of aluminum on the 14th day compared with cord blood levels of aluminum.
Results: Aluminum levels evaluated from patients’ cord blood were 3.35±1.73 g/L (18-9.7 g/L), while levels reported on day 14 were 4.79±3.54 (1.6-18.6 g/L). Aluminum levels increased by 1.44±3.86 (0.28-2.60) f/L, which was statistically significant (p=0.021). The increase in aluminum levels was highly associated with number of days that furosemide was administered (p=0.012). The increase in serum aluminum levels of patients receiving parenteral feeding for more than 10 days was found to be significantly higher. But there was no statistically significant difference. When the contents of parenteral solutions were examined, it was discovered that there was an important positive correlation between calcium and magnesium levels administered in the first seven days and serum aluminum levels on the fourteenth day (p=0.044 and p=0.008, respectively).
Conclusion: The increase in serum aluminum levels in preterm infants fed parenteral nutrition was found to be statistically significant. Longer parenteral nutrition was associated with a greater increase in serum aluminum levels.

Prematüre Hastalarda Total Parenteral Beslenmenin Plazma Alüminyum Düzeyleri Üzerine Etkileri

Amaç: Alüminyum vücutta birikerek zihinsel geliþimi bozar. kemik mineral yapýsýný etkiler ve karaciðerde kolestaza neden olur. Prematüre bebeklerde parenteral beslenme ve alüminyum geçiþinin araþtýrýlmasý amaçlandý.
Yöntem: Çalýþmamýz tek merkezli prospektif bir çalýþma olarak planlandý. Gebelik haftalarýnda ≤32 ve/veya aðýrlýðý 1500 gramýn altýnda olan 45 bebek dahil edildi. Tüm bebeklerden doðumda kordon kaný örnekleri alýndý. Ve 14. günde kandaki alüminyum seviyeleri, kordon kanýndaki alüminyum seviyeleriyle karþýlaþtýrýldý.
Sonuçlar: Hastalarýn kordon kanýndan deðerlendirilen alüminyum düzeyleri 3.35±1.73 g/L (18-9.7 g/L). 14. günde bildirilen düzeyler ise 4.79±3.54 (1.6-18.6 g/L) idi. Alüminyum seviyeleri 1.44±3.86 (0.28-2.60) f/L arttý ve bu istatistiksel olarak anlamlýydý (p=0.021). Alüminyum düzeylerindeki artýþ. furosemidin uygulandýðý gün sayýsýyla yüksek oranda iliþkiliydi (p=0.012). 10 günden fazla parenteral beslenme alan hastalarýn serum alüminyum düzeylerindeki artýþ anlamlý olarak daha yüksek bulundu ancak istatistiksel olarak anlamlý bir fark yoktu. Parenteral solüsyonlarýn içerikleri incelendiðinde ilk yedi günde uygulanan kalsiyum ve magnezyum düzeyleri ile on dördüncü gündeki serum alüminyum düzeyleri arasýnda pozitif yönde önemli bir korelasyon olduðu görüldü. (sýrasýyla p=0.044 ve p=0.008)
Sonuç: Parenteral beslenmeyle beslenen prematüre bebeklerde serum alüminyum düzeyindeki artýþ, oral beslenenlere göre istatistiksel olarak anlamlý bulundu. Daha uzun parenteral beslenme, serum alüminyum düzeylerinde daha büyük bir artýþla iliþkilendirildi. (SETB-2023-09-181)