Parenteral Zinc Intake in Newborns With Jejunostomy or Ileostomy: Results of a Monocentric Cohort Study.
Journal
Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545
Informations de publication
Date de publication:
04 2020
04 2020
Historique:
pubmed:
28
12
2019
medline:
22
6
2021
entrez:
28
12
2019
Statut:
ppublish
Résumé
The aim of the study was to assess zinc status of newborns with parenteral nutrition with or without a small bowel stoma, to determine the incidence of zinc deficit, and to determine the clinical factors associated with plasma zinc levels. Monocentric cohort study including all liveborn infants receiving zinc parenteral intake at 500 μg · kg · day and who benefited from at least 1 plasma zinc assessment during hospitalization. Sixty-eight dosages of zinc were performed in 50 newborns, divided into 3 groups (no stoma = 26, jejunostomy = 11, ileostomy = 13). Thirty-seven of the 50 infants were born preterm. The mean ± standard deviation plasma zinc was 14.9 ± 4.3 μmol/L and was similar among the 3 groups. Sixty-four percent, 3%, and 34% of zinc values were within, below, and above the normal range, respectively. In infants with jejunostomy, only 1 plasma zinc value (5%) was below the reference range. Plasma zinc levels were negatively correlated with stoma output (r = -0.449; P = 0.013). In contrast to patients with limited intestinal losses (ie, no stoma and ileostomy groups) no association between zinc levels and postmenstrual age was observed in infants with a jejunostomy suggesting that 500 μg · kg · day was adequate not only in preterm infants but also in term infants with a jejunostomy. Plasma zinc levels decrease significantly with the increase of stoma output volume of newborns with small bowel stoma. Zinc deficit was prevented in newborns with a small bowel stoma receiving of 500 μg · kg · day of parenteral zinc.
Identifiants
pubmed: 31880665
doi: 10.1097/MPG.0000000000002596
pii: 00005176-202004000-00028
doi:
Substances chimiques
Zinc
J41CSQ7QDS
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
521-526Références
Zemrani B, McCallum Z, Bines JE. Trace element provision in parenteral nutrition in children: one size does not fit all. Nutrients 2018; 10:pii: E1819.
Krebs NF, Miller LV, Hambidge KM. Zinc deficiency in infants and children: a review of its complex and synergistic interactions. Paediatr Int Child Health 2014; 34:279–288.
Balay KS, Hawthorne KM, Hicks PD, et al. Low zinc status and absorption exist in infants with jejunostomies or ileostomies which persists after intestinal repair. Nutrients 2012; 4:1273–1281.
Passariello A, Terrin G, Baldassarre ME, et al. Diarrhea in neonatal intensive care unit. World J Gastroenterol 2010; 7:2664–2668.
Gopalsamy GL, Alpers DH, Binder HJ, et al. The relevance of the colon to zinc nutrition. Nutrients 2015; 7:572–583.
Wong T. Parenteral trace elements in children: clinical aspects and dosage recommendations. Curr Opin Clin Nutr Metab Care 2012; 15:649–656.
Burjonrappa SC, Miller M. Role of trace elements in parenteral nutrition and support of the surgical neonate. J Pediatr Surg 2012; 47:760–771.
Domellöf M, Szitanyi P, Simchowitz V, et al. ESPGHAN/ESPEN/ESPR/CSPEN Working Group on Pediatric Parenteral Nutrition. ESPGHAN/ESPEN/ESPR/CSPEN guidelines on pediatric parenteral nutrition: iron and trace minerals. Clin Nutr 2018; 37:2354–2359.
Gibson RS, Hess SY, Hotz C, et al. Indicators of zinc status at the population level: a review of the evidence. Br J Nutr 2008; 99:S14–S23.
Uzzan M, Kirchgesner J, Poupon J, et al. Antioxidant trace elements serum levels in long-term parenteral nutrition (PN): prevalence and infectious risk associated with deficiencies, a retrospective study from a tertiary home-PN center. Clin Nutr 2017; 36:812–817.
Krebs NF. Update on zinc deficiency and excess in clinical pediatric practice. Ann Nutr Metab 2013; 62:19–29.
Jobe AH, Bancalari E. Bronchopulmonary dysplasia. Am J Respir Crit Care Med 2001; 163:1723–1729.
Volpe JJ. Brain injury in premature infants: a complex amalgam of destructive and developmental disturbances. Lancet Neurol 2009; 8:110–124.
Bell MJ, Ternberg JL, Feigin RD, et al. Neonatal necrotizing enterocolitis: therapeutic decisions based upon clinical staging. Ann Surg 1978; 187:1–7.
Wynn JL. Defining neonatal sepsis. Curr Opin Pediatr 2016; 28:135–140.
Fawaz R, Baumann U, Ekong U, et al. Guideline for the evaluation of cholestatic jaundice in infants: Joint Recommendations of the North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition and the European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. J Pediatr Gastroenterol Nutr 2017; 64:154–168.
International Committee for Classification of Retinopathy of Prematurity (ICCROP). The international classification of retinopathy of prematurity revisited. Arch Ophtalmol (Paris) 2005; 123:991–999.
Wani AL, Parveen N, Ansari MO, et al. Zinc: an element of extensive medical importance. Curr Med Res Pract 2017; 7:90–98.
King JC, Brown KH, Gibson RS, et al. Biomarkers of nutrition for development (BOND)-zinc review. J Nutr 2016; 146:858S–885S.
Latimer JS, McClain CJ, Sharp HL. Clinical zinc deficiency during zinc-supplemented parenteral nutrition. J Pediatr 1980; 97:434–437.
Palma PA, Conley SB, Crandell SS, et al. Zinc deficiency following surgery in zinc-supplemented infants. Pediatrics 1982; 69:801–803.
Terrin G, Berni Canani R, Di Chiara M, et al. Zinc in early life: a key element in the fetus and preterm neonate. Nutrients 2015; 7:10427–10446.
Fosmire GJ. Zinc toxicity. Am J Clin Nutr 1990; 51:225–227.
Igic PG, Lee E, Harper W, et al. Toxic effects associated with consumption of zinc. Mayo Clin Proc 2002; 77:713–716.
Grissinger M. A fatal zinc overdose in a neonate: confusion of micrograms with milligrams. PT 2011; 36:393–409.
Jeejeebhoy K. Zinc: an essential trace element for parenteral nutrition. Gastroenterology 2009; 137:S7–S12.