Jiraporn Chiaovit. A study of levels of zinc, copper, chromium and manganese in the blood of patients receiving parenteral nutrient admixture containing multi-trace elements from modified AMA formula and commercial formula . Master's Degree(Nutrition). Mahidol University. : Mahidol University, 2003.
A study of levels of zinc, copper, chromium and manganese in the blood of patients receiving parenteral nutrient admixture containing multi-trace elements from modified AMA formula and commercial formula
การศึกษาระดับสังกะสี ทองแดง โครเมียม และแมงกานีสในเลือดของผู้ป่วยที่ได้รับสารอาหารทางหลอดเลือดดำที่ผสม multi-trace element สูตรดัดแปลงจาก AMA และสูตรการค้า
Abstract:
Trace elements are minerals that are required in very small amounts for a variety of
biochemical and physiological functions. Zinc, copper, chromium and manganese are four
trace elements that the American Medical Association recommended to be added to the
parenteral nutrient admixture (PNA) for the maintenance of good nutritional status and for
nutritional rehabilitation of patients. In Thailand, there is only on commercially prepared
intravenous trace element product available, but it is very expensive. Therefore, this research
aims to study the levels of zinc, copper, chromium and manganese in the blood of patients
receiving PNA containing the AMA modified multi-trace element solution and the
commercial product, with a view to establishing the suitability or otherwise of the AMA
prduct.
The AMA modified multi-trace elements for injection were produced in suitable
conditions according to pharmaceutical process. They were visually examined to be clear of
foreign particles and were assayed to be sterile, pyrogen free and to ascertain the complete
contents and active ingredients. They were determined to be stable at ambient temperature
before being enclosed.
Two groups of patients receiving TPN in Ramathibodi Hospital were recruited for this
study. Group 1 (19 males and 11 females) received prepared AMA modified multi-trace
elements and Group 2 (19 males and 11 females) received the commercial product. Blood
samples of day 0, day3 and day10 of receiving TPN were measured by atomic absorption
spectrophotometer (model 3100, Perkin Elmer).
The results showed that levels of the four trace elements were not significantly
different between the two groups. On day 0, day 3 and day 10, the levels of zinc, copper and
manganese in the blood of both groups were significantly increased. Blood chromium levels
of group 1 were significantly increased from day 0 (0.14±0.02 μg/dL) to day 3 (0.23±0.02 μ
g/dL) but they were not significantly different between day 3 and day 10. Group 2, blood
levels of chromium from day 0 to day 10 were significantly increased.
To prevent the depletion of zinc, copper, chromium and manganese in patients
receiving PNA, it is reasonable to use the widely available AMA modified multi-trace element
product instead of the commercial alternative. It may be one way to reduce the cost of PNA
treatment.