Copper Levels in Cholestatic Infants on Parenteral Nutrition

Corkins, Mark R.; Martin, Valérie

doi:10.1177/0148607112443069

Cited by 11 publications

(8 citation statements)

References 17 publications

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“…Studying 28 PN‐dependent children who had cholestasis and were receiving this same copper dose in PN, Corkins et al found only 1 patient with elevated copper levels and found hypocupremia in half of them. Corkins et al suggested that even higher than standard dosing may be necessary for children with gastrointestinal disorders 34 . In this regard, because of the high copper content in gastrointestinal fluids, recent guidelines appropriately recommend that copper intake should be increased by 10–15 µg/kg in PN of patients, especially in those with jejunostomy 35,36 .…”

Section: Discussionmentioning

confidence: 99%

“…Corkins et al suggested that even higher than standard dosing may be necessary for children with gastrointestinal disorders. 34 In this regard, because of the high copper content in gastrointestinal fluids, recent guidelines appropriately recommend that copper intake should be increased by 10-15 µg/kg in PN of patients, especially in those with jejunostomy. 35,36 However, there is no definite consensus for adequate intravenous copper provision for IF pediatric patients with cholestasis.…”

Section: Factors Associated With Copper Deficiencymentioning

confidence: 99%

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Copper Deficiency in Children With Intestinal Failure: Risk Factors and Influence on Hematological Cytopenias

Leite

Nogueira

Uchoa

et al. 2019

J Parenter Enteral Nutr

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Background We investigated to what extent serum copper influences hemoglobin (Hb), neutrophil, and platelet counts and the factors associated with serum copper in children with intestinal failure (IF) who have their micronutrient status monitored according to a standard protocol. Methods Children with IF admitted to a pediatric intestinal rehabilitation program and receiving home parenteral nutrition (PN) were followed up prospectively. Patients received vitamins and multi–trace elements (TEs) as part of the PN. Copper, iron, zinc, vitamin A, and cobalamin serum levels were routinely monitored at 3‐month intervals or monthly when a deficiency was detected. Complete blood counts were performed biweekly. Repeated‐measures analyses were used to estimate the effect of explanatory variables on the outcomes. Results Thirteen children with a median time receiving PN of 16.6 months were included. An average of 7 copper measurements per patient were performed; 53.8% of patients had a low serum level at least twice during the follow‐up. Eight patients with cholestasis had TEs of PN discontinued. In the multivariable analysis, copper was not associated with Hb levels; an increase of 10 µg/dL in serum copper resulted in an increase of 240/mm3 (95% confidence interval [CI], 18.0–30.1) neutrophils and of 8429/mm3 (95% CI, 466–1219) platelets (P < .001). Time of PN without copper, direct bilirubin levels, and ostomy were associated with lower serum copper. Conclusion The increase in serum copper was associated with significant increases in neutrophil and platelet counts. Time without copper in PN, cholestasis, and having an ostomy negatively influenced copper status.

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Section: Discussionmentioning

confidence: 99%

Section: Factors Associated With Copper Deficiencymentioning

confidence: 99%

Copper Deficiency in Children With Intestinal Failure: Risk Factors and Influence on Hematological Cytopenias

Leite

Nogueira

Uchoa

et al. 2019

J Parenter Enteral Nutr

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“…53 Recent studies examining the practice of reducing or removing copper from PN solutions of cholestatic patients have shown that a standard intake of 20 mcg/kg/d for infants may be safe, and it is suggested that copper levels be assessed prior to reducing or removing copper from PN solutions. [54][55][56] Manganese supplementation may not be necessary for children with IFALD as manganese is a contaminant in PN solutions. 38 Therefore, use of individual trace element preparations vs a packaged trace element preparation may be the best practice in patients with IFALD.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, copper deficiency has been reported with copper‐free PN . Recent studies examining the practice of reducing or removing copper from PN solutions of cholestatic patients have shown that a standard intake of 20 mcg/kg/d for infants may be safe, and it is suggested that copper levels be assessed prior to reducing or removing copper from PN solutions . Manganese supplementation may not be necessary for children with IFALD as manganese is a contaminant in PN solutions .…”

Section: Discussionmentioning

confidence: 99%

Survey of Nutrition Management Practices in Centers for Pediatric Intestinal Rehabilitation

et al. 2017

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“…A total of 30 significant publications for pharmacy nutrition support practice were collectively identified. 2–31…”

Section: Methodsmentioning

confidence: 99%

Significant Publications for Pharmacy Nutrition Support Practice in 2013

et al. 2014

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Purpose:To assist the pharmacy clinician engaged in nutrition support in staying current with the most pertinent literature. Methods: Several experienced board-certifi ed clinical pharmacists in nutrition support compiled a list of publications published in 2013 that they considered to be important to their practice. The citation list was compiled into a Web-based survey whereby pharmacist members of the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.), GI-Liver-Nutrition Practice Research Network of the American College of Clinical Pharmacy, and the Pharmacy and Pharmacology Section of the Society of Critical Care Medicine were asked to rank each article according to level of importance in their practice. Results: A total of 30 articles were identifi ed by the author group. Thirty-six participants responded to the survey. The top-ranked papers by participants from the Web-based survey were reviewed by the authors. Due to its high level of importance, the parenteral nutrition safety consensus recommendations article, to be published in 2014 by A.S.P.E.N., was also reviewed. Conclusion: It is recommended that the informed pharmacist, who is engaged in nutrition support therapy, be familiar with the majority of these publications. Key Words-consensus, enteral nutrition, guidelines, nutrition support, outcomes, parenteral nutritionHosp Pharm-2014;49:717-730 whereby the clinical pharmacist provides pharmacotherapy services along with nutrition support responsibilities. This paradigm shift has arguably been partially attributed to the fi nancially motivated decline in the provision of interdisciplinary nutrition support teams by US hospitals over the past couple of decades. 1 S taying current with the literature is a requirement for the informed pharmacist who maintains an evidence-based clinical practice. This requirement has become increasingly more challenging to fulfi ll as a paradigm shift has changed the practice culture of a full-time pharmacy nutrition support specialist to a more integrated model

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Copper Levels in Cholestatic Infants on Parenteral Nutrition

Cited by 11 publications

References 17 publications

Copper Deficiency in Children With Intestinal Failure: Risk Factors and Influence on Hematological Cytopenias

Copper Deficiency in Children With Intestinal Failure: Risk Factors and Influence on Hematological Cytopenias

Survey of Nutrition Management Practices in Centers for Pediatric Intestinal Rehabilitation

Significant Publications for Pharmacy Nutrition Support Practice in 2013

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