Blood levels of water-soluble vitamins in pediatric patients on total parenteral nutrition using a multiple vitamin preparation

• Published in: JPEN. Journal of parenteral and enteral nutrition Vol. 13; no. 2; p. 176
• Main Authors: Marinier, E, Gorski, A M, de Courcy, G P, Criqui, C, Bunodiere, M, Christides, J P, Causse, M B, Brion, F, Ricour, C, Navarro, J
• Format: Journal Article
• Language: English
• Published: United States 01.03.1989
• Subjects: Adolescent; Ascorbic Acid - administration & dosage; Ascorbic Acid - blood; Ascorbic Acid - pharmacology; Biotin - administration & dosage; Biotin - blood; Body Weight; Child; Child, Preschool; Female; Folic Acid - administration & dosage; Folic Acid - blood; Humans; Infant; Male; Niacin - administration & dosage; Niacin - blood; Parenteral Nutrition, Total; Prospective Studies; Vitamin B Complex - administration & dosage; Vitamin B Complex - blood
• ISSN: 0148-6071; 1941-2444
• DOI: 10.1177/0148607189013002176

Although guidelines for the parenteral use of vitamin preparations in pediatric patients have been published, there are very limited data on the efficiency of these preparations and on the exact needs of infants and children on total parenteral nutrition (TPN). We report here an open, prospective, study of the blood levels of water-soluble vitamins in infants and children on TPN before and during supplementation with a new water-soluble multivitamin formula containing per vial unit: B1, 3 mg; B2, 3.6 mg; B6, 4 mg; niacin, 40 mg; pantothenate, 15 mg; ascorbate, 100 mg; biotin, 60 micrograms; folic acid, 400 micrograms; B12, 5 micrograms. Thirteen children, 9 months to 15 yr old, on home TPN for 1.5 months to 7 yr, and 17 hospitalized infants and children, 1 week to 15 yr old, receiving TPN were studied for 2 weeks to 4 months. Daily doses were given according to age: 1/2 vial if less than 18 months; 1 vial if greater than 18 months and less than 10 years; 1.5 vials if greater than 10 years. Assays for B1, B2, biotin, niacin, plasma and red blood cell (RBC) folates were performed by microbiologic methods, B12 was measured by radioimmunoassay. During the study, B1 levels were consistently above the upper limit of the normal range, B2 and B12 remained in the normal range although there was a slight decrease in B12 values. Almost half of the patients had initially low levels of biotin, niacin, and folates. Biotin, after a significant sharp rise during the first month of supplementation returned to normal range. Niacin levels were initially low in infants and rose toward normal values during treatment.