Australasian society for parenteral and enteral nutrition (AuSPEN) adult vitamin guidelines for parenteral nutrition.
Study Goal
The researchers aimed to evaluate the adequacy and safety of parenteral multivitamin preparations in avoiding deficiencies and toxicity in adult patients receiving parenteral nutrition (PN) in Australia and New Zealand.
Results Summary
The study found that current parenteral multivitamin preparations in Australia and NZ are sufficient to avoid deficiencies without causing toxicity in most clinical situations for adults receiving PN. Vitamin D was identified as the most vulnerable vitamin for this population, requiring annual monitoring.
Population
Adult patients receiving parenteral nutrition in Australia and New Zealand.
Effective Dosage
Not specified
Duration
Not specified
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
parenteral multivitamin preparations | no change | vitamin deficiency and toxicity | adults receiving PN when provided regularly as part of the PN prescription in Australia and NZ | - | are sufficient to avoid deficiency without causing toxicity | #1 |
vitamin D | decrease | vitamin status | the Australian and NZ PN population | - | is the most vulnerable vitamin | #2 |
vitamins | increase | PN adequacy | all patients receiving PN | - | are an essential component and should be provided from commencement | #3 |
vitamin D | neutral | vitamin D levels | patients receiving PN | - | is recommended to be monitored annually | #4 |
routine monitoring of vitamin levels | no change | vitamin levels | patients receiving regular parenteral multivitamin preparations | - | is unlikely to be necessary | #5 |
BACKGROUND AND OBJECTIVES: This work represents the second part of a progressive review of AuSPEN's 1999 Guidelines for Provision of Micronutrient Supplementation in adult patients receiving parenteral nutrition. METHODS AND STUDY DESIGN: A systematic literature review was undertaken and recommendations made based on the available evidence and with consideration to specific elements of the Australian and New Zealand (NZ) practice environment. The strength of evidence underpinning each recommendation was assessed. A multidisciplinary steering committee and external reviewers provided feedback on the guidelines. RESULTS: On review of the available literature it appears that the parenteral multivitamin preparations presently available in Australia and NZ are to sufficient avoid deficiency without causing toxicity in most clinical situations for adults receiving PN when provided regularly as part of the PN prescription. Vitamin D is the most vulnerable vitamin for the Australian and NZ PN population. CONCLUSIONS: Vitamins are an essential component of PN and should be provided from commencement for all patients receiving PN. With the exception of vitamin D, which is recommended to be monitored annually, routine monitoring of vitamin levels is unlikely to be necessary in patients receiving regular parenteral multivitamin preparations. Clinical judgement is an important element when assessing, prescribing and monitoring patients receiving PN. Areas requiring further research have been identified. 背景与目的：该项工作是对AuSPEN 1999年指南针对接受肠外营养（PN）的成 人患者补充微量元素进行逐步审查的第二部分。方法与研究设计：进行系统文 献综述，基于现有证据，同时考虑澳大利亚和新西兰（NZ）实践环境的特殊因 素提出了推荐。对每一项证据支撑的推荐的强度进行了评估。一个多学科指导 委员会和外部评审员对指南提供了反馈意见。结果：通过现有文献综述，发现 在澳大利亚和新西兰，现有的肠外复合维生素制剂，对常规接受PN且复合维生 素作为PN处方一部分的成年人，足以避免不足，且不会造成毒性。维生素D是 澳大利亚和新西兰人群最容易缺乏的维生素。结论：维生素是肠外营养的重要 组成部分，应为所有接受PN的患者提供维生素。除了推荐的每年监测维生素D 外，常规监测维生素含量，对接受常规复合维生素制剂的患者未必是必须的。 当评估、开处方以及监测接受PN的患者时，临床评估是个重要的因素。有待进 一步研究的领域也已经确定。.