Clinical aspects of vitamin and trace element metabolism.

An adequate provision of all micronutrients, vitamins and essential trace elements is necessary for maintenance of normal tissue function. In patients requiring nutritional support, these factors are essential for optimal utilization of the major nutrients and play a role in all aspects of intermediary metabolism. In this chapter, some of the main features of the micronutrients have been described, together with suggestions regarding their provision enterally or parenterally. For most of these nutrients, diagnostic methods are not available to permit accurate assessment of status and hence the level of provision necessary for optimal results. However, there is now sufficient understanding of nutritional requirements such that few patients should now develop clinical or biochemical signs of under- or overprovision of micronutrients.