Abstract
Routine administration of trace elements is recognised as a standard of care in children requiring parenteral nutrition. However, there is a lack of global consensus regarding trace elements provision and dosing in pediatric parenteral nutrition. This review provides an overview of available evidence regarding trace elements supply and posology in parenteral nutrition in neonates and children. Trace elements provision in children should be tailored to the weight and clinical condition of the child with emphasis on those at risk of toxicity or deficiency. Based on current evidence, there is a need to review the formulation of commercial solutions that contain multiple-trace elements and to enable individual trace elements additives to be available for specific indications. Literature supports the removal of chromium provision whereas manganese and molybdenum supplementation are debated. Preterm neonates may have higher parenteral requirements in iodine, selenium and copper than previously recommended. There is growing support for the routine provision of iron in long-term parenteral nutrition. Further studies on trace elements contamination of parenteral nutrition solutions are needed for a range of trace elements.
Highlights
Trace elements (TE) are essential nutrients required in small amounts to support normal physiological processes [1]
Trace elements should be provided to all patients requiring long-term parenteral nutrition (PN), some TE may not be required for short-term PN therapy [3]
ESPGHAN/European Society of Parenteral and Enteral Nutrition (ESPEN) 2018 guidelines [3] support the increase in selenium provision to preterm infants from 2–3 to 7 μg/kg/day based on the New Zealand study in
Summary
Trace elements (TE) are essential nutrients required in small amounts to support normal physiological processes [1]. They are required for optimal growth, development and health [2]. Trace elements should be provided to all patients requiring long-term parenteral nutrition (PN), some TE may not be required for short-term PN therapy [3]. This review discusses TE provision and posology in PN in neonates and children (
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