Premium
Assessing Copper Status in Pediatric Patients Receiving Parenteral Nutrition
Author(s) -
MacKay Mark,
Mulroy Cecilia W.,
Street Jennifer,
Stewart Charisse,
Johnsen Jake,
Jackson Daniel,
Paul Irasema
Publication year - 2015
Publication title -
nutrition in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.725
H-Index - 71
eISSN - 1941-2452
pISSN - 0884-5336
DOI - 10.1177/0884533614538457
Subject(s) - medicine , copper , parenteral nutrition , gastroenterology , copper deficiency , bilirubin , c reactive protein , inflammation , chemistry , organic chemistry
Background: Copper is a trace mineral essential for numerous physiological processes. The purpose of this article is to provide data on copper levels in pediatric patients receiving parenteral nutrition (PN) that are useful to guide supplementation in PN formulation. Method : This is a retrospective review of hospitalized pediatric patients receiving PN supplemented and not supplemented with copper. In total, 751 supplemented pediatric patients and 90 pediatric patients not supplemented had serum copper levels measured. We assessed patient demographics, days on PN before copper level was drawn, serum copper levels, conjugated bilirubin levels, and C‐reactive protein (CRP). Results : The mean serum copper level was 80 mcg/dL at 20 days for supplemented patients and 64 mcg/dL at 14 days for the 90 nonsupplemented patients ( P = .0002). In the supplemented patients, 50% of the levels were low and 45% were within the normal range. The remaining 5% of patients had high levels. In nonsupplemented patients, 71% were low and 29% within the normal range. There was no correlation between copper levels and conjugated bilirubin <2 mg/dL and >2 mg/dL ( P = .3421). Copper levels correlated with CRP for CRP >4 mg/dL ( P = .03). Conclusion : Pediatric patients receiving PN should be supplemented with copper to prevent deficiency. Serum copper levels should be assessed at 14 days. Assessment of copper status should not be determined by conjugated bilirubin levels. Serum copper levels may be elevated in patients with acute inflammation and may be falsely elevated when CRP is >4 mg/dL.