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Water‐Soluble Vitamins in Cancer Patients on Parenteral Nutrition: A Prospective Study
Author(s) -
Inculet Richard I.,
Norton Jeffrey A.,
Nichoalds George E.,
Maher Michelle M.,
White Donald E.,
Brennan Murray F.
Publication year - 1987
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607187011003243
Subject(s) - parenteral nutrition , medicine , prospective cohort study , cancer , intensive care medicine
Forty‐three patients with mild weight loss were studied prospectively to determine whether the parenteral water‐soluble vitamin doses in a commercially available preparation (MVI concentrate; USV Laboratories, Tarrytown, NY) maintained serum, red blood cell (RBC), and urinary concentrations of water‐soluble vitamins in stressed cancer patients receiving total parenteral nutrition (TPN). Patients were divided into three groups: (1) oral diet, no intravenous vitamins given; (2) TPN plus 5 ml MVI; and (3) TPN plus 10 ml MVI. Vitamins C, B 1 , B 2 , B 3 , B 6 , and niacin were measured initially and weekly during a 6‐week study period. Caloric and nitrogen balances were quantified. Most of the patients in all three groups had normal blood or urine levels of all water‐soluble vitamins. No clinical evidence of vitamin deficiency or MVI toxicitv was detected. The recommended parenteral dosages of vitamin C (100 mg/day) and B 3 (15 mg/day) provided measurably adequate levels in all patients. Levels of vitamins B 1 , B 2 , B 6 , and niacin that were less than the normal range were noted in 4–40% of patients receiving the recommended daily dosages of 3 mg, 3.6 mg, 4 mg, and 40 mg, respectively. These deficiencies appeared to improve in group III patients who received twice the recommended parenteral vitamin dosages, although they did not completely disappear. Niacin deficiency appeared to be the most prevalent, occurring in 40% of patients studied. Since intravenous doses of B 1 , B 2 , B 6 , and niacin are safe and well tolerated, it appears that increased daily amounts of these vitamins should be given to cancer patients on parenteral nutrition. (Journal of Parenteral and Enteral Nutrition 11: 243–249, 1987)