title: Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition.
abstract: OBJECTIVE
  This work represents the second part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in adult patients receiving parenteral nutrition.
  
  
  METHODS
  A systematic literature review was undertaken and recommendations made based on the available evidence and with consideration to specific elements of the Australian and New Zealand (NZ) practice environment. The strength of evidence underpinning each recommendation was assessed. A multidisciplinary steering committee and external reviewers provided feedback on the guidelines.
  
  
  RESULTS
  On review of the available literature it appears that the parenteral multivitamin preparations presently available in Australia and NZ are to sufficient avoid deficiency without causing toxicity in most clinical situations for adults receiving PN when provided regularly as part of the PN prescription. Vitamin D is the most vulnerable vitamin for the Australian and NZ PN population.
  
  
  CONCLUSIONS
  Vitamins are an essential component of PN and should be provided from commencement for all patients receiving PN. With the exception of vitamin D, which is recommended to be monitored annually, routine monitoring of vitamin levels is unlikely to be necessary in patients receiving regular parenteral multivitamin preparations. Clinical judgement is an important element when assessing, prescribing and monitoring patients receiving PN. Areas requiring further research have been identified.
authors.affiliation: Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Butterfield Street, Brisbane, Australia. Email: Emma.Osland@health.qld.gov.au.|Faculty of Health and Behavioural Sciences, School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Australia.
authors.forename: Emma J
authors.initials: EJ
authors.lastname: Osland
authors.affiliation: Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia.
authors.forename: Azmat
authors.initials: A
authors.lastname: Ali
authors.affiliation: Department of Pharmacy, Middlemore Hospital, Auckland, New Zealand.
authors.forename: Truc
authors.initials: T
authors.lastname: Nguyen
authors.affiliation: Mel Davis and Associates, Sydney, Australia.
authors.forename: Melvyn
authors.initials: M
authors.lastname: Davis
authors.affiliation: Nutrition Support Team, Auckland City Hospital, Auckland, New Zealand.|Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand.
authors.forename: Lyn
authors.initials: L
authors.lastname: Gillanders
mesh_terms: D000328:Adult; D001315:Australia; D004750:Enteral Nutrition; D006801:Humans; D009520:New Zealand; D010288:Parenteral Nutrition / Q000379:methods*; D012955:Societies, Medical; D014815:Vitamins / Q000008:administration & dosage* / Q000633:toxicity
chemical_list: D014815:Vitamins