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Vitamin E and total parenteral nutrition.

Abstract
Vitamin E and essential fatty acid status were examined in two groups of patients, one receiving fat-free total parenteral nutrition (TPN) with intravenous all-rac-alpha-tocopherol for vitamin E deficiency and the other receiving routine intravenous fat (Intralipid, 10%) emulsions with TPN to supply both fatty acid and vitamin E requirements. Initial evaluation of both groups revealed a 50% incidence of vitamin E deficiency, platelet hyperaggregation, or in vitro H2O2-induced hemolysis. Only platelet hyperaggregation correlated significantly with vitamin E deficiency. Supplementation with all-rac-alpha-tocopherol corrected platelet hyperaggregation and H2O2-induced hemolysis; daily dosage requirements of 25-50 mg (fat-free TPN) or more (with intravenous fat) suggest increased vitamin E requirements during TPN. Intravenous fat emulsion did not correct the platelet and red blood cell abnormalities, a result of either increased vitamin E requirements or low alpha-tocopherol-equivalent content of the emulsion. Essential fatty acid deficiency (EFAD) was observed in seven patients with an associated platelet hyperaggregation independent of vitamin E deficiency. Prolonged TPN for enterocutaneous fistulae in three patients was associated with persistent EFAD and platelet hyperaggregation despite up to 2.0 liters of intravenous fat emulsion weekly.
AuthorsP M Thurlow, J P Grant
JournalAnnals of the New York Academy of Sciences (Ann N Y Acad Sci) Vol. 393 Pg. 121-32 ( 1982) ISSN: 0077-8923 [Print] United States
PMID6816120 (Publication Type: Journal Article, Research Support, U.S. Gov't, P.H.S.)
Chemical References
  • Fatty Acids, Essential
  • Peroxides
  • Vitamin E
  • Adenosine Diphosphate
  • Epinephrine
Topics
  • Adenosine Diphosphate (pharmacology)
  • Epinephrine (pharmacology)
  • Fatty Acids, Essential (deficiency)
  • Hemolysis (drug effects)
  • Humans
  • Nutrition Disorders (prevention & control)
  • Nutritional Requirements
  • Parenteral Nutrition
  • Parenteral Nutrition, Total
  • Peroxides (pharmacology)
  • Platelet Aggregation (drug effects)
  • Vitamin E (blood, metabolism)

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