Abstract
No studies have been done to evaluate AMA guidelines for Pediatric intravenous vitamins. Two age groups received the AMA suggested dosages as MVI Pediatric: 1) Infants less than 1500 gm (N=21) for 3 wks (65% of Pediatric dose) and 2) Term newborns up to age 10 yrs (N=24) for < 4 wks and, N=8 for 3-6 months). Water soluble vitamin blood levels were normal (B1, B2, B3, B5) or elevated (folate, B12, pantothenate) in all patients. Lipid soluble vitamins D and E were maintained at normal levels (15-39 ng/ml and 0.25-1.3 mg/dl respectively) in all patients in group 2 for up to 6 months on TPN. Vitamin A levels were below the lower normal range (20 mcg/dl) for two patients in group 2 and all but two infants in group 1. Infants receiving oral Vitamin E in addition to MVI showed higher blood tocopherol levels than those not receiving oral tocopherol (wk 1 = 2.32 ± 0.2 vs 1.3 ± 0.1 mg/dl, p < 0.01; wk 3 = 1.4 ± 0.08 vs 2.9 ± 0.4, p > 0.01). Tests of Vitamin A demonstrated = 80% loss in TPN solutions exposed to light and intravenous tubing. This effect was reversed by infusing MVI in Intralipid.
Conclusion. With the exception of Vitamin A, AMA guidelines appear appropriate for infants and children receiving TPN. The low Vitamin A blood levels can be explained from losses from light exposure and adherence to plastic I.V. tubing, a phenomenon obviated by the addition of the vitamins to Intralipid. No oral Vitamin E should be given with MVI Pediatric in TPN.
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Greene, H., Moore, M., Phillips, B. et al. 658 VITAMIN LEVELS IN INFANTS AND CHILDREN RECEIVING PARENTERAL NUTRITION. Pediatr Res 19, 220 (1985). https://doi.org/10.1203/00006450-198504000-00688
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DOI: https://doi.org/10.1203/00006450-198504000-00688