1O2 + FA OH° + FA° Singlet Oxygen Hydroxyl Radical

PUFA + OH° PUFA° + H2O PUFA Radical

PUFA° + O2 PUFAO2°

PUFA Peroxide Radical

PUFAO2° + PUFA PUFAO2H + PUFA° Lipid Hydroperoxide

Breakdown Products (toxic)

Lipid Peroxidation

Factors influencing LPOin parenteral lipid admixtures

Oxygen

(Ambient) Light

Temperature

Micronutrients

Trace elements (Cu, Fe, Se)

Vitamins (E, A, C)

0

1

2

3

4

1 4 8 14 19 29

days of storage

peroxide values[mmol peroxides/L]

0.8

20-30°C / daylight; with TE20-30°C / daylight 2-8°C / light-protected with TE 2-8°C / light-protected

Steger, Mühlebach JPEN 2000;24:37-41

Lipid peroxidation of AIO admixtures:Influence of trace elements (TE) and storage conditions