Better preemie survival rates by blocking light to IVs not yet a reality

Blocking UV light from reaching the intravenous nutrients used to feed premature babies could improve their survival rates, but only if shielded IV bags, tubes and other equipment become available, Canadian doctors say.

Premature infants born between 26 and 31 weeks gestation are fed intravenously because their immature digestive systems aren't yet able to handle nutrients taken by mouth.

Lesley Donaldson-Reid's son was born three months premature. Torran weighed 2½ pounds and was fed oxygen and nutrients through tubes.

"There was heartache after heartache," his Toronto mother recalled. "We almost lost him on the sixth day of his life. He almost died."

When the nutrient solution is exposed to light, toxic or oxidizing molecules are produced. In a fragile preemie like Torran was, the antioxidant defences aren't able to cope.

By keeping the nutrients in the dark, it's thought that babies are able to absorb the key protein, fat and glucose they need to grow and develop.  

Individual studies on blocking the light didn't include enough infants for researchers to find an effect. But recently, researchers at the University of Montreal and Children's and Women's Health Centre of BC in Vancouver reviewed studies on about 800 preterm infants who were fed from solutions exposed to light or that were shielded.

It was only by combining the studies that the effect became clear, the researchers said.

Major advance

When the solution was not exposed to light, it was less toxic and deaths among preemies declined by 50 per cent, the team reported in a meta-analysis published online in the Journal of Parenteral and Enteral Nutrition. 

"I categorize that as a major advance in clinical neonatal practice," said study co-author Jean-Claude Lavoie of the University of Montreal. "The last time you had a reduction of half the mortality in this population is a generation ago, 20, 25 years ago."

Study co-author Dr. Philippe Chessex also surveyed Canadian hospitals in 2009 on light protection in their neonatal intensive care units.

 "Your first reaction is this is a very good news story and we're going to be able to make a difference," Chessex said from Montreal. The pediatrician is an emeritus professor from the University of British Columbia.

But Chessex found half of hospitals did not shield at all and half offered only partial shielding of just bags or tubing.

Partial shielding measures don't go far enough. The researchers found the nutrient solutions need to be shielded from the moment they're created in the pharmacy to the time they're delivered through tubes and IV bags to protect preterm babies.

That's why Chessex is calling on health authorities, regulators and industry partners to get together and make opaque tubing and pump controls available to block light for preemie patients. So far, amber-coloured components seem to work best and still allow health-care workers to see what's flowing.

As for Torran, he now lives with complications related to his premature birth. But he's a busy and thriving seven-year-old.