Parenteral trace elements in children:  clinical aspects and dosage recommendations.
OBJECTIVE
Since the 1970s, it has been known that the supplementation of trace elements with parenteral nutrition is required in order to avoid the clinical manifestations of their deficiencies. However, the correct level of requirements of these trace elements, particularly in paediatrics, has provided some debate. The recent developments might help revise some of the current recommendations, particularly in short-term parenteral nutrition provision.


RESULTS
Parenterally fed preterm neonates require routine addition of zinc. Provision of chromium and manganese in parenteral nutrition should be limited, particularly for short-term patients. Newer parenteral iron preparations provide the opportunity for a safer and larger dose of administration.


CONCLUSIONS
Clinicians should prescribe according to the individual requirements and revise the routine practice of providing 'all in one' parenteral trace elements preparations, as these products do not reflect or allow tailored provision in paediatrics and may increase the risk of toxicity.
Department of Gastroenterology and Hepatology, Royal Children's Hospital, Herston, Queensland, Australia. theowong@hotmail.com
Theodoric
T
Wong
D002648:Child; D002857:Chromium / Q000008:administration & dosage; D003300:Copper / Q000008:administration & dosage; D019587:Dietary Supplements; D006801:Humans; D007455:Iodine / Q000008:administration & dosage; D019266:Iron, Dietary / Q000008:administration & dosage; D044342:Malnutrition / Q000188:drug therapy*; D008345:Manganese / Q000008:administration & dosage; D010288:Parenteral Nutrition; D012643:Selenium / Q000008:administration & dosage; D014131:Trace Elements / Q000008:administration & dosage* / Q000172:deficiency*; D015032:Zinc / Q000008:administration & dosage
D019266:Iron, Dietary; D014131:Trace Elements; D002857:Chromium; D008345:Manganese; D003300:Copper; D007455:Iodine; D012643:Selenium; D015032:Zinc