Nutrients 2012, 4(12), 1977-1988; doi:10.3390/nu4121977
Review

Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants

1 School of Allied Health Professionals, University of Nebraska Medical Center, Omaha, NE 984045, USA 2 Pharmacy and Nutrition Care Services, Nebraska Medical Center, Omaha, NE 984045, USA 3 Alegent Health Bergan Mercy Medical Center, 7500 Mercy Road, Omaha, NE 68124, USA 4 College of Pharmacy, University of Nebraska Medical Center, Omaha, NE 986045, USA 5 College of Pediatrics, University of Nebraska Medical Center, Omaha, NE 981205, USA
* Author to whom correspondence should be addressed.
Received: 12 October 2012; in revised form: 29 November 2012 / Accepted: 30 November 2012 / Published: 7 December 2012
(This article belongs to the Special Issue Parenteral Nutrition)
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Abstract: Nutrition support practitioners are currently dealing with shortages of parenteral nutrition micronutrients, including multivitamins (MVI), selenium and zinc. A recent survey from the American Society of Enteral and Parenteral Nutrition (ASPEN) indicates that this shortage is having a profound effect on clinical practice. A majority of respondents reported taking some aggressive measures to ration existing supplies. Most premature infants and many infants with congenital anomalies are dependent on parenteral nutrition for the first weeks of life to meet nutritional needs. Because of fragile health and poor reserves, they are uniquely susceptible to this problem. It should be understood that shortages and rationing have been associated with adverse outcomes, such as lactic acidosis and Wernicke encephalopathy from thiamine deficiency or pulmonary and skeletal development concerns related to inadequate stores of Vitamin A and D. In this review, we will discuss the current parenteral shortages and the possible impact on a population of very low birth weight infants. This review will also present a case study of a neonate who was impacted by these current shortages.
Keywords: TPN; premature infant; nutrient deficiencies; neonate

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MDPI and ACS Style

Hanson, C.; Thoene, M.; Wagner, J.; Collier, D.; Lecci, K.; Anderson-Berry, A. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants. Nutrients 2012, 4, 1977-1988.

AMA Style

Hanson C, Thoene M, Wagner J, Collier D, Lecci K, Anderson-Berry A. Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants. Nutrients. 2012; 4(12):1977-1988.

Chicago/Turabian Style

Hanson, Corrine; Thoene, Melissa; Wagner, Julie; Collier, Dean; Lecci, Kassandra; Anderson-Berry, Ann. 2012. "Parenteral Nutrition Additive Shortages: The Short-Term, Long-Term and Potential Epigenetic Implications in Premature and Hospitalized Infants." Nutrients 4, no. 12: 1977-1988.

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