Trace Elements in Parenteral Nutrition

Fessler, Theresa A.

doi:10.1177/0884533613506596

Cited by 34 publications

(8 citation statements)

References 54 publications

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“…Zn 2þ and Cu 2þ [44,45]), while trivalent metals, whose affinity for InsP 6 is very much higher than divalents [46] and which are essential dietary components (e.g. Cr 3þ [47]), have not been studied in this context. Overall, this leads us to the conclusion that chronically altering cation absorption from the gut by artificially loading the diet with a non-specific chelator [39] in the hope that it might impact indirectly on cancer or other pathologies seems highly inadvisable.…”

Section: Discussionmentioning

confidence: 99%

A novel method for the purification of inositol phosphates from biological samples reveals that no phytate is present in human plasma or urine

et al. 2015

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Inositol phosphates are a large and diverse family of signalling molecules. While genetic studies have discovered important functions for them, the biochemistry behind these roles is often not fully characterized. A key obstacle in inositol phosphate research in mammalian cells has been the lack of straightforward techniques for their purification and analysis. Here we describe the ability of titanium dioxide (TiO2) beads to bind inositol phosphates. This discovery allowed the development of a new purification protocol that, coupled with gel analysis, permitted easy identification and quantification of InsP6 (phytate), its pyrophosphate derivatives InsP7 and InsP8, and the nucleotides ATP and GTP from cell or tissue extracts. Using this approach, InsP6, InsP7 and InsP8 were visualized in Dictyostelium extracts and a variety of mammalian cell lines and tissues, and the effects of metabolic perturbation on these were explored. TiO2 bead purification also enabled us to quantify InsP6 in human plasma and urine, which led to two distinct but related observations. Firstly, there is an active InsP6 phosphatase in human plasma, and secondly, InsP6 is undetectable in either fluid. These observations seriously question reports that InsP6 is present in human biofluids and the advisability of using InsP6 as a dietary supplement.

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Section: Discussionmentioning

confidence: 99%

A novel method for the purification of inositol phosphates from biological samples reveals that no phytate is present in human plasma or urine

et al. 2015

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“…Thus, positive results in those trials cannot be clearly attributed solely to Se supplementation. Notwithstanding this, according to the concept of nutrient replacement, by which micronutrient substitution is aimed at replenishing losses and target restoration of physiological function [60], Se must be supplemented at standard doses by the enteral (77–100 μg/day) or the parenteral (100–400 μg/day) route [61] because the results of our meta-analysis do not refute previously recommended Se substitution doses.…”

Section: Discussionmentioning

confidence: 99%

High-dose intravenous selenium does not improve clinical outcomes in the critically ill: a systematic review and meta-analysis

et al. 2016

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BackgroundSelenium (Se) is an essential trace element with antioxidant, anti-inflammatory, and immunomodulatory effects. So far, several randomized clinical trials (RCTs) have demonstrated that parenteral Se may improve clinical outcomes in intensive care unit (ICU) patients. Since publication of our previous systematic review and meta-analysis on antioxidants in the ICU, reports of several trials have been published, including the largest RCT on Se therapy. The purpose of the present systematic review was to update our previous data on intravenous (IV) Se in the critically ill.MethodsWe searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials. We included RCTs with parallel groups comparing parenteral Se as single or combined therapy with placebo. Potential trials were evaluated according to specific eligibility criteria, and two reviewers abstracted data from original trials in duplicate independently. Overall mortality was the primary outcome; secondary outcomes were infections, ICU length of stay (LOS), hospital LOS, ventilator days, and new renal dysfunction.ResultsA total of 21 RCTs met our inclusion criteria. When the data from these trials were aggregated, IV Se had no effect on mortality (risk ratio [RR] 0.98, 95 % CI 0.90–1.08, P = 0.72, heterogeneity I 2 = 0 %). In addition, when the results of ten trials in which researchers reported on infections were statistically aggregated, there was no significant treatment effect of parenteral Se (RR 0.95, 95 % CI 0.88–1.02, P = 0.15, I 2 = 0 %). There was no positive or negative effect of Se therapy on ICU and hospital LOS, renal function, or ventilator days.ConclusionsIn critically ill patients, IV Se as monotherapy does not improve clinical outcomes.Electronic supplementary materialThe online version of this article (doi:10.1186/s13054-016-1529-5) contains supplementary material, which is available to authorized users.

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“…Selenium functions via proteins known as selenoproteins [39,40]. The most important selenoprotein is glutathione peroxidase (GSH-Px), which assists the body in defending against oxidative stress by reducing cell membrane damage from lipid hydroperoxides and hydrogen peroxide.…”

Section: Trace Elementsmentioning

confidence: 99%

“…Past recommendations for dosages have fluctuated, but the most recent recommendation from A.S.P.E.N. is 60–100 mcg/day for PN trace element formulations [3,39,43]. Btaiche et al [17] found in their review of HPN patients that a dose of 70 mcg/day, which was above the A.S.P.E.N.…”

Section: Trace Elementsmentioning

confidence: 99%

Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician

2017

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Trace elements (TEs) are an essential component of parenteral nutrition (PN). Over the last few decades, there has been increased experience with PN, and with this knowledge more information about the management of trace elements has become available. There is increasing awareness of the effects of deficiencies and toxicities of certain trace elements. Despite this heightened awareness, much is still unknown in terms of trace element monitoring, the accuracy of different assays, and current TE contamination of solutions. The supplementation of TEs is a complex and important part of the PN prescription. Understanding the role of different disease states and the need for reduced or increased doses is essential. Given the heterogeneity of the PN patients, supplementation should be individualized.

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Trace Elements in Parenteral Nutrition

Cited by 34 publications

References 54 publications

A novel method for the purification of inositol phosphates from biological samples reveals that no phytate is present in human plasma or urine

A novel method for the purification of inositol phosphates from biological samples reveals that no phytate is present in human plasma or urine

High-dose intravenous selenium does not improve clinical outcomes in the critically ill: a systematic review and meta-analysis

Trace Elements in Parenteral Nutrition: Considerations for the Prescribing Clinician

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