title: Multiple micronutrient deficiencies among patients with intestinal failure during and after transition to enteral nutrition.
abstract: OBJECTIVE
  To determine the prevalence of deficiencies of specific micronutrients (iron, zinc, magnesium, phosphorus, selenium, copper, folate, and vitamins A, D, E, and B12) in children with intestinal failure (IF), and to identify risk factors associated with developing these deficiencies.
  
  
  METHODS
  This study was a retrospective review of prospectively collected data from 178 children with IF managed by the Intestinal Care Center of Cincinnati Children's Hospital Medical Center between August 1, 2007, and July 31, 2012. Transition to full enteral nutrition (FEN) was defined as the period during which the patient received between 20% and 100% of estimated required nutrition enterally. FEN was defined as the patient's ability to tolerate 100% estimated required nutrition enterally for >2 weeks.
  
  
  RESULTS
  Necrotizing enterocolitis was the most common cause of IF (27.5%). Iron was the most common micronutrient deficiency identified both during (83.9%) and after (61%) successful transition to FEN, with a significant reduction in the percentage of patients with iron deficiency between these 2 periods (P = .003). Predictors of micronutrient deficiency after successful transition to FEN included birth weight (P = .03), weight percentile (P = .02), height percentile (P = .04), and duration of parenteral nutrition (PN) (P = .013). After multivariate adjustments, only duration of PN remained statistically significant (P = .03).
  
  
  CONCLUSIONS
  Micronutrient deficiencies persist in patients with IF during and after transition to FEN. These data support the need for routine monitoring and supplementation of these patients, especially those on prolonged PN.
authors: Intestinal Rehabilitation Program, Intestinal Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Nigeria Teaching Hospital, Ituku/Ozalla, Enugu, Nigeria. Electronic address: agozie.ubesie@unn.edu.ng.
authors: Agozie C
authors: AC
authors: Ubesie
authors: Samuel A
authors: SA
authors: Kocoshis
authors: Adam G
authors: AG
authors: Mezoff
authors: Carol J
authors: CJ
authors: Henderson
authors: Michael A
authors: MA
authors: Helmrath
authors: Conrad R
authors: CR
authors: Cole
mesh_terms: D002675:Child, Preschool; D003677:Deficiency Diseases / Q000453:epidemiology / Q000209:etiology; D004750:Enteral Nutrition; D005260:Female; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000628:therapy*; D008297:Male; D018977:Micronutrients / Q000172:deficiency*; D015995:Prevalence; D012189:Retrospective Studies
chemical_list: D018977:Micronutrients
keywords: EN; Enteral nutrition; FEN; Full enteral nutrition; HAZ; Height-for-age z-score; IF; Intestinal failure; PN; Parenteral nutrition; WAZ; Weight-for-age z-score
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