Zinc and copper abnormalities in fasting patients undergoing total parenteral nutrition

Low serum levels of zinc and copper have recently been reported in association with TPN and the fasting state. A prospective study during May 1977 through November 1978 was performed in 28 patients undergoing TPN. Serum and urinary Zn and Cu levels were detected; the patient population was divided in septic and non septic groups and each was subdivided according to plasma administration. In both groups low serum Zn and Cu levels were detected. The urinary losses were greater in the group with sepsis. Three patients had clinical manifestations of Zn deficiency, in two it was reversible with the administration of diet or oral Zn. The third one died of sepsis. The low serum levels found in our patients suggested that plasma administration might be insufficient to cover the daily requirements of such elements. This requirement is augmented by the increased urinary losses seen in septic postoperative stages.