Advances in Trace Element Supplementation for Parenteral Nutrition. 2022

Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
Nutrition Services, University of Virginia Children's Hospital, Charlottesville, VA 22903, USA.

Parenteral nutrition (PN) provides support for patients lacking sufficient intestinal absorption of nutrients. Historically, the need for trace element (TE) supplementation was poorly appreciated, and multi-TE products were not initially subjected to rigorous oversight by the United States Food and Drug Administration (FDA). Subsequently, the American Society for Parenteral and Enteral Nutrition (ASPEN) issued dosage recommendations for PN, which are updated periodically. The FDA has implemented review and approval processes to ensure access to safer and more effective TE products. The development of a multi-TE product meeting ASPEN recommendations and FDA requirements is the result of a partnership between the FDA, industry, and clinicians with expertise in PN. This article examines the rationale for the development of TRALEMENT® (Trace Elements Injection 4*) and the FDA's rigorous requirements leading to its review and approval. This combination product contains copper, manganese, selenium, and zinc and is indicated for use in adults and pediatric patients weighing ≥10 kg. Comprehensive management of PN therapy requires consideration of many factors when prescribing, reviewing, preparing, and administering PN, as well as monitoring the nutritional status of patients receiving PN. Understanding patients' TE requirements and incorporating them into PN is an important part of contemporary PN therapy.

UI MeSH Term Description Entries
D008345 Manganese A trace element with atomic symbol Mn, atomic number 25, and atomic weight 54.94. It is concentrated in cell mitochondria, mostly in the pituitary gland, liver, pancreas, kidney, and bone, influences the synthesis of mucopolysaccharides, stimulates hepatic synthesis of cholesterol and fatty acids, and is a cofactor in many enzymes, including arginase and alkaline phosphatase in the liver. (From AMA Drug Evaluations Annual 1992, p2035)
D010288 Parenteral Nutrition The administering of nutrients for assimilation and utilization by a patient who cannot maintain adequate nutrition by enteral feeding alone. Nutrients are administered by a route other than the alimentary canal (e.g., intravenously, subcutaneously). Intravenous Feeding,Nutrition, Parenteral,Parenteral Feeding,Feeding, Intravenous,Feeding, Parenteral,Feedings, Intravenous,Feedings, Parenteral,Intravenous Feedings,Parenteral Feedings
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D004364 Pharmaceutical Preparations Drugs intended for human or veterinary use, presented in their finished dosage form. Included here are materials used in the preparation and/or formulation of the finished dosage form. Drug,Drugs,Pharmaceutical,Pharmaceutical Preparation,Pharmaceutical Product,Pharmaceutic Preparations,Pharmaceutical Products,Pharmaceuticals,Preparations, Pharmaceutical,Preparation, Pharmaceutical,Preparations, Pharmaceutic,Product, Pharmaceutical,Products, Pharmaceutical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012643 Selenium An element with the atomic symbol Se, atomic number 34, and atomic weight 78.97. It is an essential micronutrient for mammals and other animals but is toxic in large amounts. Selenium protects intracellular structures against oxidative damage. It is an essential component of GLUTATHIONE PEROXIDASE. Selenium-80,Selenium 80
D014131 Trace Elements A group of chemical elements that are needed in minute quantities for the proper growth, development, and physiology of an organism. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 4th ed) Biometal,Biometals,Trace Element,Trace Mineral,Trace Minerals,Element, Trace,Elements, Trace,Mineral, Trace,Minerals, Trace
D014481 United States A country in NORTH AMERICA between CANADA and MEXICO.
D019587 Dietary Supplements Products in capsule, tablet or liquid form that provide dietary ingredients, and that are intended to be taken by mouth to increase the intake of nutrients. Dietary supplements can include macronutrients, such as proteins, carbohydrates, and fats; and/or MICRONUTRIENTS, such as VITAMINS; MINERALS; and PHYTOCHEMICALS. Food Supplements,Neutraceuticals,Dietary Supplementations,Food Supplementations,Herbal Supplements,Nutraceuticals,Nutriceuticals,Dietary Supplement,Food Supplement,Herbal Supplement,Neutraceutical,Nutraceutical,Nutriceutical,Supplement, Food,Supplement, Herbal,Supplementations, Dietary,Supplements, Dietary,Supplements, Food,Supplements, Herbal

Related Publications

Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
January 2009, Nutrition (Burbank, Los Angeles County, Calif.),
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
November 2009, Gastroenterology,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
October 1989, Nihon eiseigaku zasshi. Japanese journal of hygiene,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
December 2016, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
January 1995, Nutrition (Burbank, Los Angeles County, Calif.),
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
April 2014, Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
January 2014, Asia Pacific journal of clinical nutrition,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
June 1976, Surgery,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
February 1978, American journal of hospital pharmacy,
Patti Perks, and Emily Huynh, and Karolina Kaluza, and Joseph I Boullata
March 1989, The American journal of clinical nutrition,
Copied contents to your clipboard!