Background Immaturity of antioxidant defense coupled with oxidant load is suspected to induce the development of bronchopulmonary dyplasia (BPD) in premature infants. Peroxide load from total parenteral nutrition (TPN) is associated with oxidative stress in this population. We hypothesize that the oxidative stress and, consequently, the severity of BPD, both increase in function of duration of TPN infusion.
Objective To document the relation between the duration of TPN as well as the redox potential of glutathione measured in blood and the severity of BPD.
Design/methods GSH and GSSG from whole blood sampled at 36 weeks of corrected age in 51 infants less than 29 weeks of gestational age, were measured by capillary electrophoresis in order to calculate the redox potential (Nernst equation). Severity of BPD was classified according to NICH guidelines (Job and Bancalari, 2001). Means (s.e.m). (n = 5–21 per group) were compared by ANOVA.
Results The duration of TPN in days was strongly associated (p<0.001) with the severity of BPD. A logestic regression model confirmed the independent effect of TPN.
Conclusions The duration of the oxidant load from TPN exacerbates the oxidative stress in preterm infants as observed with the more oxidized status of the redox potential in infants having received TPN for a longer time. The strong relation between severity of BPD and duration of TPN could be explained by this oxidative stress generated by the TPN.