{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T03:45:25Z","timestamp":1790221525770,"version":"4.1.0"},"reference-count":11,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2020,6,21]],"date-time":"2020-06-21T00:00:00Z","timestamp":1592697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Nutrients"],"abstract":"<jats:p>The ESPGHAN\/ESPEN\/ESPR-Guidelines on pediatric parenteral nutrition (PPN) recommend the administration of the semiessential amino acid (AA) cysteine to preterm neonates due to their biochemical immaturity resulting in an inability to sufficiently synthetize endogenous cysteine. The soluble precursor N-acetylcysteine (NAC) is easily converted into bioavailable cysteine. Its dimer N,N-diacetylcystine (DAC) is almost unconvertable to cysteine when given intravenously resulting in a diminished bioavailability of cysteine. This study aims to understand the triggers and oxidation process of NAC to DAC to evaluate possibilities of reducing DAC formation in standardized PPN. Therefore, different air volumes (21% O2) were injected into the AA compartment of a standardized dual-chamber PPN. O2 concentrations were measured in the AA solution and the headspaces of the primary and secondary packaging. NAC and DAC concentrations were analyzed simultaneously. The analysis showed that O2 is principally delivered from the primary headspace. NAC oxidation exclusively delivers DAC, depending on the O2 amount in the solution and the headspaces. The reaction of NAC to DAC being containable by limiting the O2 concentration, the primary headspace must be minimized during manufacturing, and oxygen absorbers must be added into the secondary packaging for a long-term storage of semipermeable containers.<\/jats:p>","DOI":"10.3390\/nu12061849","type":"journal-article","created":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T06:46:12Z","timestamp":1592808372000},"page":"1849","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Stability of N-Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of N,N-Diacetylcystine (DAC) Formation"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1765-293X","authenticated-orcid":false,"given":"Isabelle","family":"Sommer","sequence":"first","affiliation":[{"name":"Department of Pharmacy, University Hospital of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herv\u00e9","family":"Schwebel","sequence":"additional","affiliation":[{"name":"B. Braun Medical AG, 1023 Crissier, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent","family":"Adamo","sequence":"additional","affiliation":[{"name":"B. Braun Medical AG, 1023 Crissier, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pascal","family":"Bonnabry","sequence":"additional","affiliation":[{"name":"Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, 1211 Geneva, Switzerland"},{"name":"Department of Pharmacy, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucie","family":"Bouchoud","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Geneva University Hospitals, 1205 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshid","family":"Sadeghipour","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, University Hospital of Lausanne, 1011 Lausanne, Switzerland"},{"name":"Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, University of Lausanne, 1211 Geneva, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2409","DOI":"10.1016\/j.clnu.2018.06.955","article-title":"ESPGHAN\/ESPEN\/ESPR guidelines on pediatric parenteral nutrition: Standard versus individualized parenteral nutrition","volume":"37","author":"Riskin","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"2315","DOI":"10.1016\/j.clnu.2018.06.945","article-title":"ESPGHAN\/ESPEN\/ESPR guidelines on pediatric parenteral nutrition: Amino acids","volume":"37","author":"Carnielli","year":"2018","journal-title":"Clin. Nutr."},{"key":"ref_3","first-page":"CD004869","article-title":"Cysteine, cystine or N-acetylcysteine supplementation in parenterally fed neonates","volume":"4","author":"Soghier","year":"2006","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.1093\/ajcn\/86.4.1120","article-title":"Cysteine: A conditionally essential amino acid in low-birth-weight preterm infants?","volume":"86","author":"Riedijk","year":"2007","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1177\/0148607106030002133","article-title":"N-Acetylcysteine is a Highly Available Precursor for Cysteine in the Neonatal Piglet Receiving Parenteral Nutrition","volume":"30","author":"Shoveller","year":"2006","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_6","first-page":"89","article-title":"Cystein in der parenteralen Ern\u00e4hrung: Vergleichende Studie \u00fcber N-Acetylcystein und N,N-Diacetylcystin am Modell der Ratte","volume":"15","author":"Wagner","year":"1988","journal-title":"Infus. Klin. Ern\u00e4hrung."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"479","DOI":"10.1016\/S0021-9673(99)00727-X","article-title":"Capillary electrophoretic separation of N-acetylcysteine and its impurities as a method for quality control of pharmaceuticals","volume":"853","author":"Jaworska","year":"1999","journal-title":"J. Chromatogr. A."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1177\/0148607194018005404","article-title":"Amino Acid Solutions for Premature Neonates During the First Week of Life: The Role of N-Acetyl-L-Cysteine and N-Acetyl-L-Tyrosine","volume":"18","author":"Sulkers","year":"1994","journal-title":"J. Parenter. Enter. Nutr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1111\/j.1527-3466.2003.tb00110.x","article-title":"The Antiatherogenic Effect of DiNAC: Experimental Findings Supporting Immunomodulation as a New Treatment for Atherosclerosis Related Diseases","volume":"21","author":"Pettersson","year":"2003","journal-title":"Cardiovasc. Drug Rev."},{"key":"ref_10","first-page":"1174","article-title":"N,N9-Diacetyl-L-cystine\u2014The Disulfide Dimer of N-acetylcysteine\u2014Is a Potent Modulator of Contact Sensitivity\/Delayed Type Hypersensitivity Reactions in Rodents","volume":"288","author":"Jansson","year":"1999","journal-title":"Am. Soc. Pharmacol. Exp. Ther."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1631","DOI":"10.1093\/jn\/112.8.1631","article-title":"Formation of Maillard Reaction Products in Parenteral Nutrition Solutions","volume":"8","author":"Fry","year":"1982","journal-title":"J. Nutr."}],"container-title":["Nutrients"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/6\/1849\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:41:24Z","timestamp":1760175684000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6643\/12\/6\/1849"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6,21]]},"references-count":11,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6]]}},"alternative-id":["nu12061849"],"URL":"https:\/\/doi.org\/10.3390\/nu12061849","relation":{},"ISSN":["2072-6643"],"issn-type":[{"value":"2072-6643","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,6,21]]}}}