Selected ultratrace elements in total parenteral nutrition solutions

Area of Science:

• Clinical Nutrition
• Trace Element Metabolism
• Parenteral Nutrition

Background:

• Ultratrace elements can be essential or toxic to human health.
• Long-term total parenteral nutrition (TPN) patients risk significant ultratrace element exposure via TPN solutions.
• Contaminants in TPN solutions pose an underappreciated risk for patients receiving long-term nutritional support.

Purpose of the Study:

• To quantify the intake of selected ultratrace elements from standard TPN solutions.
• To compare TPN-derived ultratrace element intake with absorption from dietary sources in healthy individuals.
• To assess the potential health implications of ultratrace element contamination in TPN.

Main Methods:

• Analysis of a standard TPN solution to determine ultratrace element concentrations.
• Calculation of daily ultratrace element intake for TPN patients based on solution analysis.
• Comparison of TPN-derived intake with established values for gastrointestinal absorption from food.

Main Results:

• Widespread and variable contamination of TPN solutions with multiple ultratrace elements was observed.
• Daily intakes of molybdenum (Mo), nickel (Ni), vanadium (V), and cadmium (Cd) from TPN contamination were comparable to normal dietary absorption.
• Aluminum (Al) intake from TPN was notably high, while boron (B) intake was low (approx. 10% of normal absorption).

Conclusions:

• Standard TPN solutions are a significant source of unintended ultratrace element exposure.
• The biological impact of intravenously administered ultratrace elements requires further investigation.
• Particular attention is needed for patients on home TPN regarding potential ultratrace element toxicity.