Abstract
Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of the effects of deficiencies and toxicities of certain trace elements. Despite this heightened awareness, much is still unknown in terms of trace element monitoring, the accuracy of different assays, and current TE contamination of solutions. The supplementation of TEs is a complex and important part of the PN prescription. Understanding the role of different disease states and the need for reduced or increased doses is essential. Given the heterogeneity of the PN patients, supplementation should be individualized.
Highlights
Trace elements (TE) are essential components of complexes required for fundamental processes such as enzymatic reactions
Group of the American Medical Association (NAG-AMA) published guidelines submitted to the Food and Drug Administration (FDA) for daily TEs considered essential for human health in parenteral nutrition: zinc, copper, manganese, and chromium [1]
As patients were maintained on home parenteral nutrition (HPN) for longer durations of time, additional light was shed on TEs
Summary
Trace elements (TE) are essential components of complexes required for fundamental processes such as enzymatic reactions. Group of the American Medical Association (NAG-AMA) published guidelines submitted to the Food and Drug Administration (FDA) for daily TEs considered essential for human health in parenteral nutrition: zinc, copper, manganese, and chromium [1]. As patients were maintained on home parenteral nutrition (HPN) for longer durations of time, additional light was shed on TEs. In the following decades, as more information came from toxicity and balance studies, as well as reports in the literature of PN contamination, further adjustments to recommended doses were made [3]. The processes of inflammation, infection, and oxidative stress increase the metabolic requirements for certain trace elements. There are currently a variety of pre-mixed multi-TE combinations that are commercially available for addition to parenteral nutrition (PN) solutions
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