Evaluation of a trace element preparation in patients receiving home intravenous nutrition

Although home parenteral nutrition (HPN) is an established treatment in the management of chronic intestinal failure [l], much remains to be learned about its biochemical and nutritional consequences. There is a paucity of nutritional data relating to virtually all aspects of long-term intravenous nutrition (IVN). The requirements for energy substrates and amino-acids are reasonably well established from oral dietary studies and a range of suitable preparations are available [2]. On the other hand, a recent study of trace element provisions to patients on home intravenous nutrition concluded that none of the presently available commercial preparations was ideal for use in this patient population [3]. In particular, zinc provision from commercial preparations generally required further supplementation, copper requirements were variable, and manganese and chromium provision was excessive in many cases. None of the preparations contained selenium. Few centres have sufficient patient numbers to conduct studies into efficacy of particular preparations. For this reason data are often pooled from several centres, but this is complicated by local variation in feeding regimens and solutions used. The Nutrition Unit, Hope Hospital, Salford is the largest UK centre for HPN [4]. We have evaluated the recently developed trace element preparation Additracea (Kabi Vitrum, Stockholm) (Table 1) in 24 patients requiring longterm intravenous nutrition.