Vitamins are essential in
total parenteral nutrition (TPN), their importance being highlighted by repeated past documentation of various
vitamin deficiencies particularly in patients on long-term
parenteral nutrition therapy. This study evaluated the efficacy of water- (Soluvit) and fat-soluble (Vitalipid)
vitamin supplementation in patients receiving
total parenteral nutrition using the three in one 3-liter bag system. All patients received water-soluble
vitamin supplements daily. Fat-soluble
vitamin supplements were administered on a daily or twice weekly basis. Twenty-two patients were studied. In seven of the 22 patients
vitamin status was assessed on more than one occasion during TPN support, thus bringing the total number of observations to 30. The mean duration of TPN support was 35 days. Eight of the observations were made during less than 10 days, three between 11-19 days, 15 between 20-60 days, and four during more than 60 days of TPN support. Biochemical deficiency as judged by subnormal
enzyme activity or
vitamin levels were present in 10% of the patients for
thiamin, 3% for
riboflavin, and 6% for
nicotinic acid. By contrast 83% of the patients had low plasma
vitamin C and B6 levels. Low plasma
vitamin A and E levels were also present in 43 and 40% of the patients, respectively. According to the plasma concentrations of the
vitamins studied it would appear that the commercial
vitamin preparations used in this study are inadequate in maintaining optimal
vitamin status.(ABSTRACT TRUNCATED AT 250 WORDS)