Serum trace elements in children receiving long-term parenteral nutrition.

The trace elements iron (Fe), copper (Cu), zinc (Zn), selenium (Se), chromium (Cr), manganese (Mn), nickel (Ni), rubidium (Rb), and bromine (Br) were determined in serum from 18 children, ages 4 to 65 months, who received long-term total parenteral nutrition (TPN). Nine patients (group 1) received TPN as their only source of nutrition; the other nine (group 2) ingested 30% to 70% of their total calorie requirement and received the remainder intravenously. The reference group consisted of 19 healthy children of similar age and sex distribution. Groups 1 and 2 had received parenteral nutrition for 28.4 +/- 13.7 (SD) and 23.1 +/- 17.1 (SD) months, respectively. All patients in group 1 and four in group 2 had short bowel syndrome; four in group 2 had pseudo-obstruction syndrome. Patients in group 1 had normal serum levels of Fe, Cu, and Mn, but increased levels of Zn; they had decreased serum concentrations of Se, Cr, Ni, Rb, and Br. Patients in group 2 had decreased serum levels of Mn, Cr, Ni, Rb, and Br. Those trace elements not supplemented in TPN solutions (Se, Cr, Mn, Ni, Rb, and Br) were lower in the children receiving TPN than in the control children, indicating inadequate intake of these trace elements from food and TPN solutions. However, no obvious clinical signs or symptoms of trace element deficiencies were observed.