Stability of -Acetylcysteine (NAC) in Standardized Pediatric Parenteral Nutrition and Evaluation of ,-Diacetylcystine (DAC) Formation.

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 -acetylcysteine (NAC) is easily converted into bioavailable cysteine. Its dimer ,-diacetylcystine (DAC) is almost unconvertable to cysteine when given intravenously resulting in a diminished bioavailability of cysteine.