title: Parenteral nutrition additive shortages: the short-term, long-term and potential epigenetic implications in premature and hospitalized infants.
abstract: Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI), selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN) indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages.
authors.affiliation: School of Allied Health Professionals, University of Nebraska Medical Center, Omaha, NE 984045, USA. ckhanson@unmc.edu
authors.forename: Corrine
authors.initials: C
authors.lastname: Hanson
authors.forename: Melissa
authors.initials: M
authors.lastname: Thoene
authors.forename: Julie
authors.initials: J
authors.lastname: Wagner
authors.forename: Dean
authors.initials: D
authors.lastname: Collier
authors.forename: Kassandra
authors.initials: K
authors.lastname: Lecci
authors.forename: Ann
authors.initials: A
authors.lastname: Anderson-Berry
mesh_terms: D000013:Congenital Abnormalities / Q000628:therapy; D003677:Deficiency Diseases / Q000209:etiology* / Q000235:genetics; D044127:Epigenesis, Genetic; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000209:etiology* / Q000235:genetics; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000628:therapy; D019102:Infant, Very Low Birth Weight; D018977:Micronutrients / Q000172:deficiency*; D009751:Nutritional Requirements; D057947:Parenteral Nutrition Solutions / Q000600:supply & distribution*; D010289:Parenteral Nutrition, Total
chemical_list: D018977:Micronutrients; D057947:Parenteral Nutrition Solutions