Is daily mvi required in patients receiving parenteral nutrition?

Between November 1996 and January 1999 there was a nationwide shortage of intravenous multivitamins (MVI) in the US. We investigated whether patients who received parenteral nutrition (PN) with MVI three times per week instead of daily developed clinical manifestations of vitamin deficiency during that period. Five patients were enrolled in the study All received home PN as their sole source of nutrition for at least six months. None of these patients showed clinical manifestations of vitamin deficiency. In addition, compared to daily MVI administration, supplementation with MVI three times per week saved $1,000 per patient per year. This preliminary study raises the question of how much MVI is needed to prevent vitamin deficiency. Using MVI three days a week instead of daily would substantially reduce the cost of treatment and might reduce the risk of infections for these patients.