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Parenteral trace elements in children: clinical aspects and dosage recommendations

Wong, Theodoric

Current Opinion in Clinical Nutrition & Metabolic Care: November 2012 - Volume 15 - Issue 6 - p 649–656
doi: 10.1097/MCO.0b013e3283582187
MICRONUTRIENTS: Edited by Gil Hardy and Henry Lukaski

Purpose of review Since the 1970s, it has been known that the supplementation of trace elements with parenteral nutrition is required in order to avoid the clinical manifestations of their deficiencies. However, the correct level of requirements of these trace elements, particularly in paediatrics, has provided some debate. The recent developments might help revise some of the current recommendations, particularly in short-term parenteral nutrition provision.

Recent findings Parenterally fed preterm neonates require routine addition of zinc. Provision of chromium and manganese in parenteral nutrition should be limited, particularly for short-term patients. Newer parenteral iron preparations provide the opportunity for a safer and larger dose of administration.

Summary Clinicians should prescribe according to the individual requirements and revise the routine practice of providing ‘all in one’ parenteral trace elements preparations, as these products do not reflect or allow tailored provision in paediatrics and may increase the risk of toxicity.

Department of Gastroenterology and Hepatology, Royal Children's Hospital, Herston, Queensland, Australia

Correspondence to Dr Theodoric Wong, Department of Gastroenterology and Nutrition, Birmingham Children's Hospital, Steelhouse Lane, Birmingham B4 6NH, West Midlands, UK. Tel: +44 121 3338705; fax: +44 121 333 8701; e-mail:

© 2012 Lippincott Williams & Wilkins, Inc.