A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products.
The parenteral multivitamin preparations that are commercially available in the United States (U.S.) meet the requirements for most patients who receive parenteral nutrition (PN). However, a separate parenteral vitamin D preparation (cholecalciferol or ergocalciferol) should be made available for treatment of patients with vitamin D deficiency unresponsive to oral vitamin D supplementation. Carnitine is commercially available and should be routinely added to neonatal PN formulations. Choline should also be routinely added to adult and pediatric PN formulations; however, a commercially available parenteral product needs to be developed. The parenteral multi-trace element (TE) preparations that are commercially available in the U.S. require significant modifications. Single-entity trace element products can be used to meet individual patient needs when the multiple-element products are inappropriate (see Summary/A.S.P.E.N. Recommendations section for details of these proposed modifications).
St. Elizabeth Health Center, Youngstown, OH 44501-1790, USA. vince_vanek@hmis.org
Vincent W
VW
Vanek
Peggy
P
Borum
Alan
A
Buchman
Theresa A
TA
Fessler
Lyn
L
Howard
Khursheed
K
Jeejeebhoy
Marty
M
Kochevar
Alan
A
Shenkin
Christina J
CJ
Valentine
D001361:Avitaminosis / Q000188:drug therapy; D002331:Carnitine / Q000008:administration & dosage; D002794:Choline / Q000008:administration & dosage; D019587:Dietary Supplements; D004046:Dietetics / Q000592:standards; D017408:Guidelines as Topic; D006801:Humans; D009751:Nutritional Requirements; D010288:Parenteral Nutrition / Q000592:standards*; D057947:Parenteral Nutrition Solutions / Q000592:standards*; D014131:Trace Elements / Q000008:administration & dosage* / Q000172:deficiency; D014481:United States; D014486:United States Food and Drug Administration; D014815:Vitamins / Q000008:administration & dosage*
D057947:Parenteral Nutrition Solutions; D014131:Trace Elements; D014815:Vitamins; D002794:Choline; D002331:Carnitine