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Recommendations for Manganese Supplementation to Adult Patients Receiving Long‐Term Home Parenteral Nutrition
Author(s) -
Baker Bradley,
Ali Azmat,
Isenring Liz
Publication year - 2016
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 - 10.1177/0884533615591600
Subject(s) - medicine , parenteral nutrition , pediatrics , intensive care medicine
Manganese (Mn) toxicity is often observed in adult patients receiving long‐term home parenteral nutrition (HPN), and differing recommendations on the safe level of Mn administration to these patients have been made in the literature over the past 10 years. Methods: This systematic review used the National Health and Medical Research Council (NHMRC) evidence hierarchy to assess the design and strength of individual studies (high I to low IV) and the overall grade of evidence (grade A high to grade D low). Results: Eight studies met the inclusion criteria. Levels of evidence ranged from high (NHMRC II) to mid‐level (III‐3). A widespread recommendation in the literature for patients receiving long‐term HPN is 55 µg (1 µmol) Mn/d. Conclusion: The recommendation of 55 µg (1µmol) Mn/d is of moderate‐strength evidence (NHMRC B grade). There is limited evidence to support not supplementing Mn to patients receiving long‐term HPN. Further intervention studies providing high‐level evidence (II and above) are required to determine the safety of not supplementing Mn to all patients receiving long‐term HPN.