Vitamin K requirements in patients receiving total parenteral nutrition

The vitamin K requirements of 47 adult patients on total parenteral nutrition (TPN) were investigated by randomly allocating them to receive either 0.15 mg vitamin K1 (1 ampoule of 'Vitlipid') per week or 20.15 mg vitamin K1 (1 ampoule of 'Vitlipid' plus 10 mg vitamin K X 2) per week. Vitamin K1 in a dose of 0.15 mg was as effective as a dose of 20.15 mg per week in maintaining a normal BCR (British Corrected Ratio) in most TPN patients. Seven patients in each group developed a BCR greater than 1.3; this was significantly associated with the use of cephalosporin antibiotics and responded to 10 mg vitamin K1 per day. Most patients receiving parenteral feeding require no more vitamin K than that provided by 1 ampoule of 'Vitlipid' per week. Regular monitoring of the BCR, especially in patients on antibiotics, will reveal those who need more. Such patients need 10 mg vitamin K1 per day.