Incidence of Hypertriglyceridemia in critically ill neonates receiving lipid injectable emulsions in glass versus plastic containers: A retrospective analysis

Objective To evaluate plasma clearance of lipid injectable emulsions packaged in either glass or plastic containers in neonates from 2 7-month periods, 1 year apart. Study design Clinical records from June I to December 31, 2003 (glass [G] period) and the same months in 2004 (plastic [P] period) were assessed. Neonates who received lipid injectable emulsions were studied. Lipid container (glass vs plastic) was the independent variable. Results Of the 1.97 patients studied, 122 (G, 50/81; P, 72/116) had evaluable triglyceride (TG) levels, for an overall rate of 62%. Only birth weight (G. 1.09 +/- 0.32 kg vs P, 1.23 +/-.45 kg) and birth length (G. 36.4 +/- 3.5 cm vs P. 37.9 +/- 3.5 cm) were significantly different between the 2 groups (P =.047 and .028. respectively). There were no differences in the day of life on which lipid injection was started, the lipid dose. or the timing of TG measurements. The incidence of hypertriglyceridemia was significantly higher in the P period (G. 3/50 vs P. 19/72; P =.004). Conclusions Administration of the same lipid formulation in plastic bags compared with glass containers is associated with higher rates of hypertriglyceridemia. The poorer clearance of lipids could be due to a higher proportion of large-diameter far globules in plastic bags compared with those in glass containers.