This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Labadarios, D. Articles by Shephard, G. S. Search for Related Content PubMed PubMed Citation Articles by Labadarios, D. Articles by Shephard, G. S. Social Bookmarking                         What's this?

Plasma Vitamin Levels in Patients on Prolonged Total Parenteral Nutrition

MRC Metabolic Research Group, Tygerberg Hospital, Department of Internal Medicine, University of Stellenbosch, Tygerberg

Stephen J.D. O'Keefe, M.D., M.Sc., M.R.C.P.

Nutrition Unit and Gastrointestinal Clinic, Groote Schuur Hospital, University of Cape Town, Observatory, South Africa

Joy Dicker, B.Sc.

Nutrition Unit and Gastrointestinal Clinic, Groote Schuur Hospital, University of Cape Town, Observatory, South Africa

Liza Van Stuijvenberg, B.SC. HONS.

MRC Metabolic Research Group, Tygerberg Hospital, Department of Internal Medicine, University of Stellenbosch, Tygerberg

Lizaan Visser, B.SC.

MRC Metabolic Research Group, Tygerberg Hospital, Department of Internal Medicine, University of Stellenbosch, Tygerberg

Maria E.J. Louw, M.SC.

MRC Metabolic Research Group, Tygerberg Hospital, Department of Internal Medicine, University of Stellenbosch, Tygerberg

Gordon S. Shephard, PH.D.

MRC Metabolic Research Group, Tygerberg Hospital, Department of Internal Medicine, University of Stellenbosch, Tygerberg

Vitamins are essential in total parenteral nutrition (TPN), their importance being highlighted by repeated past documentation of various vitamin deficiencies particularly in patients on long-term parenteral nutrition therapy. This study evaluated the efficacy of water- (Soluvit) and fat-soluble (Vitalipid) vitamin supplementation in patients receiving total parenteral nutrition using the three in one 3-liter bag system. All patients received water-soluble vitamin supplements daily. Fat-soluble vitamin supplements were administered on a daily or twice weekly basis. Twenty-two patients were studied. In seven of the 22 patients vitamin status was assessed on more than one occasion during TPN support, thus bringing the total number of observations to 30. The mean duration of TPN support was 35 days. Eight of the observations were made during less than 10 days, three between 11-19 days, 15 between 20-60 days, and four during more than 60 days of TPN support. Biochemical deficiency as judged by subnormal enzyme activity or vitamin levels were present in 10% of the patients for thiamin, 3% for riboflavin, and 6% for nicotinic acid. By contrast 83% of the patients had low plasma vitamin C and B6 levels. Low plasma vitamin A and E levels were also present in 43 and 40% of the patients, respectively. According to the plasma concentrations of the vitamins studied it would appear that the commercial vitamin preparations used in this study are inadequate in maintaining optimal vitamin status. Our results indicate that on the basis of the low plasma concentrations found, vitamin deficiencies can occur in patients when commercial preparations are used that do not comply with the current guidelines of maintenance requirements. We further recommend that vitamin status assessment, when possible, is incorporated in the overall patient management. (Journal of Parenteral and Enteral Nutrition 12:205-211, 1988)

Journal of Parenteral and Enteral Nutrition, Vol. 12, No. 2, 205-211 (1988)
DOI: 10.1177/0148607188012002205


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				J. U. Burnes, S. J.D. O'Keefe, C. R. Fleming, R. M. Devine, S. Berkner, and L. Herrick Home Parenteral Nutrition--A 3-Year Analysis of Clinical and Laboratory Monitoring JPEN J Parenter Enteral Nutr, July 1, 1992; 16(4): 327 - 332. [Abstract] [PDF]

				P. P. Purdum III and D. F. Kirby Review: Short-Bowel Syndrome: A Review of the Role of Nutrition Support JPEN J Parenter Enteral Nutr, January 1, 1991; 15(1): 93 - 101. [Abstract] [PDF]