Thiamine status in patients receiving long-term home parenteral nutrition Journal Article

Authors: Schiano, T. D.; Klang, M. G.; Quesada, E.; Scott, F.; Tao, Y.; Shike, M.
Article Title: Thiamine status in patients receiving long-term home parenteral nutrition
Abstract: Objectives: Clinical thiamine deficiency can occur in patients receiving total parenteral nutrition (TPN) without thiamine supplementation. Because considerable breakdown of thiamine may occur in the presence of bisulfite- containing amino acid solutions, subclinical thiamine deficiency may develop with the use of these solutions, even with appropriate thiamine supplementation. The current American Medical Association-Food and Drug Administration approved injectable multivitamin formula contains 3 mg of thiamine. This study was undertaken to determine whether this quantity of thiamine is sufficient to avoid clinical thiamine deficiency in long-term home TPN patients with negligible oral thiamine absorption and in the presence of bisulfite-containing amino acid solutions. Methods: Twenty-four long-term home TPN patients with oral caloric intakes below the norm were evaluated. Seventeen patients suffered from short bowel syndrome or radiation enteritis, and another three had draining gastrostomies that precluded all intestinal absorption. The duration of TPN therapy ranged between 1 and 164 months. Thiamine status was assessed by assaying thiamine pyrophosphate, transketolase activity, and blood thiamine levels. Results: All thiamine pyrophosphate and erythrocyte transketolase activity levels were within the normal range. Conclusions: This study demonstrates that the currently recommended 3 mg of thiamine hydrochloride added to TPN solutions is adequate to maintain normal thiamine status. This should prevent the development of thiamine deficiency even in patients with compromised intestinal thiamine absorption, and in the presence of bisulfite-containing amino acid solutions.
Keywords: adolescent; adult; clinical article; school child; aged; aged, 80 and over; middle aged; time factors; reference values; total parenteral nutrition; home care; radiation enteropathy; gastrostomy; short bowel syndrome; erythrocytes; bisulfite; supplementation; vitamin blood level; thiamine pyrophosphate; cocarboxylase; thiamine; humans; human; male; female; priority journal; article; thiamine deficiency; travasol; transketolase; parenteral nutrition, home
Journal Title: American Journal of Gastroenterology
Volume: 91
Issue: 12
ISSN: 0002-9270
Publisher: Nature Publishing Group  
Date Published: 1996-12-01
Start Page: 2555
End Page: 2559
Language: English
PUBMED: 8946985
PROVIDER: scopus
Notes: Article -- Export Date: 22 November 2017 -- Source: Scopus