Renée Blaauw1, Emma Osland2,3, Krishnan Sriram4, Azmat Ali5, Johane P Allard6, Patrick Ball7, Lingtak-Neander Chan8, Brian Jurewitsch9, Kathleen Logan Coughlin10, William Manzanares11, Ana Maria Menéndez12, Rina Mutiara13, Ricardo Rosenfeld14, Marianna Sioson15, Janicke Visser1, Mette M Berger16. 1. Division of Human Nutrition, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa. 2. Department of Nutrition and Dietetics, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia. 3. School of Human Movement and Nutrition Sciences, University of Queensland, Brisbane, Queensland, Australia. 4. US Department of Veterans Affairs, Regional Tele-ICU System (VISN 23), Hines, Illinois, USA. 5. Department of Nutrition and Dietetics, Princess Alexandra Hospital, Brisbane, Queensland, Australia. 6. Division of Gastroenterology, Toronto General Hospital, University of Toronto, Toronto, Ontario, Canada. 7. School of Pharmacy, University of Wolverhampton, Wolverhampton, UK. 8. Department of Pharmacy School of Pharmacy, and Graduate Program in Nutritional Sciences, School of Public Health, University of Washington, Seattle, Washington, USA. 9. Specialized Complex Care Program, St. Michael's Hospital, Faculty of Pharmacy, University of Toronto, Toronto, Canada. 10. Center for Human Nutrition, Digestive Disease and Surgical Institute, Cleveland Clinic, Cleveland, Ohio, USA. 11. Department of Critical Care, Faculty of Medicine. Hospital de Clínicas, Universidad de la República (UdelaR), Montevideo, Uruguay. 12. Clinical Pharmacy, University de Belgrano, Buenos Aires, Argentina. 13. Pharmacy Department, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. 14. Nutrition Support Department, Casa de Saude Sao Jose, Associacao Congregacao de Santa Catarina, Rio de Janeiro, Brazil. 15. Section of Nutrition, Department of Medicine, The Medical City Hospital, Pasig City, Metro Manila, Philippines. 16. Faculty of Biology and Medicine, Service of Intensive Care Medicine & Burns, University of Lausanne Hospitals (CHUV), Lausanne, Switzerland.
Abstract
BACKGROUND: Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines' recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients. METHODS: Based on the available evidenced-based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper. RESULTS: The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided. CONCLUSION: Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision-including voluntary omission, partial provision, and supply issues-must be overcome to allow safe and responsible nutrition practice.
BACKGROUND: Micronutrients, an umbrella term used to collectively describe vitamins and trace elements, are essential components of nutrition. Those requiring alternative forms of nutrition support are dependent on the prescribed nutrition regimen for their micronutrient provision. The purpose of this paper is to assist clinicians to bridge the gap between the available guidelines' recommendations and their practical application in the provision of micronutrients via the parenteral route to adult patients. METHODS: Based on the available evidenced-based literature and existing guidelines, a panel of multidisciplinary healthcare professionals with significant experience in the provision of parenteral nutrition (PN) and intravenous micronutrients developed this international consensus paper. RESULTS: The paper addresses 14 clinically relevant questions regarding the importance and use of micronutrients in various clinical conditions. Practical orientation on how micronutrients should be prescribed, administered, and monitored is provided. CONCLUSION: Micronutrients are a critical component to nutrition provision and PN provided without them pose a considerable risk to nutrition status. Obstacles to their daily provision-including voluntary omission, partial provision, and supply issues-must be overcome to allow safe and responsible nutrition practice.
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