Parenteral Nutrients and Formulations


BOX 3.3 Daily Vitamin Requirements for Adult Parenteral Nutrition17 Vitamin


Thiamin (B1)


Riboflavin (B2) Niacin (B3) Folic acid


Pantothenic acid (B5) Pyridoxine (B6)


Cyanocobalamin (B12) Biotin (B7)


Ascorbic acid (vitamin C) Vitamin A Vitamin D Vitamin E Vitamin K


3.6 mg 40 mg


600 mcg 15 mg 6 mg


5 mcg


60 mcg 200 mg


3,300 IU (990 mcg) 200 IU (5 mcg) 15 IU (10 mg) 150 mcg


Adapted with permission from Mirtallo J, Canada T, Johnson D, et al. Safe practices for parenteral nutrition. JPEN J Parenter Enteral Nutr. 2004;28(6):S39-S70. doi:10.1177/0148607104028006s39 17


Standard daily requirement 6 mg


Trace Elements Trace element requirements are outlined in Box 3.4 on page 42.17,29


Com-


mercially available products include single-entity or combination prepara- tions. Multiple trace element preparation products provide trace element amounts that meet requirements as outlined by the AMA. Traditionally, combination formulations included chromium, copper, manganese, sele- nium, and zinc. More recently, limits on the number of components in the admixture were established to minimize trace element contamination in the final PN infusate. For example, chromium may be present as a contam- inant from other PN components at a level that would meet the estimated requirement for chromium. Therefore, the FDA-recommended formula- tion did not warrant the inclusion of chromium. Both FDA-approved com- bination trace element products available in the United States currently contain only copper, manganese, selenium, and zinc.30


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