PARENTERAL INTAKE OF VITAMINS AND TRACE ELEMENTS IN CHILDREN ON HOME PARENTERAL NUTRITION: CAN WE MEET ESPGHAN RECOMMENDATIONS USING FIXED-DOSE MULTIVITAMIN/TRACE ELEMENT PRODUCTS? – EXPERIENCES FROM A REGIONAL PAEDIATRIC INTESTINAL FAILURE SERVICE
Thank you for your poster. Really interesting! Can I ask if you also checked CRP level and what you think was the reason for low vitamin D and vitamin K? Did you look at blood levels of the micronutrients as well? Do you ever measure serum phylloquinone/PIVKA II in practice?
Hello Sarah, thank you for your comment. In the audit we only compared the patients’ intake of micronutrients from PN and compared it to the ESPGHAN recommendations. The products we commonly use in PN that provide fat soluble vitamins do not provide anywhere near the recommended quantity of vitamin D or K in the dose advised.
We do routinely assess blood micronutrient levels, but this was not included in this audit. We do tend to check CRP along with the micronutrient bloods, as we are aware it can influence the reliability of specific results. We do not routinely assess phylloquinone/PIVKA II in practice, but this is something that we plan to consider.
Hi Anthony, this is interesting. We do not routinely consider oral supplementation in our PN patients due to very questionable absorption – but perhaps something is better than nothing!
Thank you for your poster. Really interesting! Can I ask if you also checked CRP level and what you think was the reason for low vitamin D and vitamin K? Did you look at blood levels of the micronutrients as well? Do you ever measure serum phylloquinone/PIVKA II in practice?
Hello Sarah, thank you for your comment. In the audit we only compared the patients’ intake of micronutrients from PN and compared it to the ESPGHAN recommendations. The products we commonly use in PN that provide fat soluble vitamins do not provide anywhere near the recommended quantity of vitamin D or K in the dose advised.
We do routinely assess blood micronutrient levels, but this was not included in this audit. We do tend to check CRP along with the micronutrient bloods, as we are aware it can influence the reliability of specific results. We do not routinely assess phylloquinone/PIVKA II in practice, but this is something that we plan to consider.
A significant proportion of our HPN cohort are on oral Vit D supplements to optimise Vit D/PTH values
Hi Anthony, this is interesting. We do not routinely consider oral supplementation in our PN patients due to very questionable absorption – but perhaps something is better than nothing!