Iodine Supplementation for Pediatric Patients Receiving Long-Term Parenteral Nutrition.
BACKGROUND
Patients dependent on parenteral nutrition (PN) are among a group at risk of developing iodine deficiency. Supplementation with iodine in this population has been debated in a number of studies, resulting in variable clinical practices. The Committee on Clinical Practice Issues of the American Society for Clinical Nutrition recommends a dose of 1 mcg/kg/d of parenteral iodine for patients receiving PN. At our institution, PN trace elements do not include iodine, although this is not the case internationally. Our study sought to assess iodine levels and thyroid function in a cohort of PN-dependent pediatric patients.


METHODS
A retrospective analysis studied 32 pediatric patients with a variety of medical diagnoses who received PN as a primary means of nutrition for 6 months or longer. Patients received variable proportions of their total caloric intake as PN, which ranged from 14%-100%. Iodine and thyroid function levels were obtained by serum sampling.


RESULTS
No patient in our cohort of 32 demonstrated thyroid dysfunction or developed iodine deficiency. The length of time on PN and the percentage of total nutrition intake as PN were not associated with iodine levels (P < .89 and P < .73, respectively). There were no significant associations between age (P < .342), clinical diagnosis (P < .46), or sex (P < .43) on iodine status. There were no incidences of abnormal iodine levels in our cohort. Our study suggests that pediatric patients older than 6 months receiving PN may not benefit from iodine supplementation, but further investigation is needed.
Stanford University School of Medicine, Department of Pediatrics, Palo Alto California jsantoro@stanford.edu.
Jonathan D
JD
Santoro
Lucile Packard Children's Hospital Stanford, Pharmacy Department, Palo Alto, California.
Colleen
C
Nespor
Lucile Packard Children's Hospital Stanford, Pharmacy Department, Palo Alto, California.
Robert L
RL
Poole
Stanford University School of Medicine, Department of Pediatrics, Division of Gastroenterology, Palo Alto, California.
John A
JA
Kerner
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D002149:Energy Intake; D005260:Female; D006801:Humans; D007223:Infant; D007455:Iodine / Q000008:administration & dosage* / Q000097:blood / Q000172:deficiency; D008297:Male; D009752:Nutritional Status; D010288:Parenteral Nutrition; D012189:Retrospective Studies; D013959:Thyroid Diseases / Q000097:blood / Q000175:diagnosis; D013972:Thyrotropin / Q000097:blood; D013974:Thyroxine / Q000097:blood
D013972:Thyrotropin; D007455:Iodine; D013974:Thyroxine
iodine; parenteral nutrition; parenteral nutrition solutions; pediatrics; thyroid function tests