Perspectives on parenteral micronutrient shortages.

Area of Science:

• Clinical Nutrition
• Parenteral Nutrition
• Micronutrient Metabolism

Background:

• Micronutrients are vital in parenteral nutrition (PN).
• Deficiency and toxicity issues arise from commercial product content, dosing errors, and high-risk patient populations.
• Commercial product shortages exacerbate deficiency risks.

Purpose of the Study:

• Review evidence on patients at risk for micronutrient deficiency.
• Examine the rationale for micronutrient product reformulation.
• Describe deficiency characteristics during product shortages.

Main Methods:

• Literature review of clinical practice and product shortages.
• Analysis of patient risk factors for micronutrient deficiency.
• Evaluation of evidence regarding micronutrient product formulation and deficiency signs.

Main Results:

• Identified patient groups at high risk for micronutrient deficiency in PN.
• Highlighted safety concerns with suboptimal or absent micronutrient administration during shortages.
• Detailed clinical manifestations of micronutrient deficiencies during supply disruptions.

Conclusions:

• Current PN practices face challenges with micronutrient management.
• Product shortages pose significant risks, necessitating careful management and potentially reformulated products.
• Ensuring adequate and safe micronutrient provision is critical for PN patients.