Abstract
Since the introduction of long-term parenteral nutrition for patients with intestinal failure, morbidity due to inadequate replacement of micronutrients has been well described. More recently, recognition of hypermanganesemia and its associated complications has become an issue in the patient receiving long-term parenteral nutrition. The intent of this report is to provide a brief overview of manganese in parenteral nutrition and offer some practical suggestions to avoid manganese intoxication. A normal 70-kg person contains about 12 to 20 mg of manganese, which is widely distributed in tissues as the two manganesecontaining metalloenzymes, pyruvate carboxylase and superoxide dismutase, both of which are located in the mitochondria.1,2
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