Serum vitamin A and E concentrations in pediatric total parenteral nutrition patients.
There is uncertainty as to optimal doses of fat soluble vitamins required by pediatric total parenteral nutrition (TPN) patients. We compared serum vitamin A (A) and E (E) concentrations analyzed by HPLC in chronic (greater than 2 weeks) TPN patients aged 1 month to 12 years to values obtained in out-patient surgery patients of the same age. TPN patients received 1500 micrograms of retinol and 2.5 IU of E as alpha-tocopheryl acetate (2.5 ml LyphoMed Multi Vitamin Concentrate). These doses were 214% of the recommended dose of A and 36% for E. Oral intake was minimal in most patients. The results of our study revealed a mean serum A level for TPN patients (N = 29) of 26.0 +/- 15.0 (SD) micrograms/dl vs 25.0 +/- 10.0 (SD) micrograms/dl in controls (N = 52). Mean serum E was 0.63 +/- 0.24 (SD) mg/dl vs 0.89 +/- 0.31 (SD) mg/dl for TPN patients and controls, respectively. There was no consistent trend related to duration of TPN for 23 patients with serial values. Seven (24%) TPN patients had serum A greater than mean + 2 SD of control (p less than 0.01). No values were less than mean - 2 SD. Infants on TPN had a significantly lower mean serum A (22.3 +/- 10.9 micrograms/dl) than TPN patients greater than 1 year of age (34.1 +/- 16.0 micrograms/dl; p less than 0.001). Fifty-two percent of TPN patients vs 26% of control had serum A less than 20 micrograms/dl (p greater than 0.1). For E, one patient had a high value and two patients low values relative to control.(ABSTRACT TRUNCATED AT 250 WORDS)
Hack
S L
SL
Department of Pediatrics, Childrens Hospital of Los Angeles, School of Medicine, University of Southern California.
Merritt
R J
RJ
Morgan
R M
RM
Keefe
M T
MT
D002648:Child; D002675:Child, Preschool; D005260:Female; D005526:Food, Formulated; D006801:Humans; D007223:Infant; D008297:Male; D010289:Parenteral Nutrition, Total; D010372:Pediatrics; D014801:Vitamin A / Q000008:administration & dosage / Q000097:blood*; D014810:Vitamin E / Q000008:administration & dosage / Q000097:blood*; D014815:Vitamins / Q000008:administration & dosage
D014815:Vitamins; D014801:Vitamin A; D014810:Vitamin E