小児外科患児の経静脈栄養輸液におけるビタミン投与について

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Vitamin status (B, B, Folic acid, Biotin, A, D and E) in pediatric surgical patients under-going intravenous hyperalimentation (IVH) over 4 weeks was studied and following results were obtained. 1. 20 patients aged between 8 months and 3 years with no evidence of liver damage nor abnormal loss of intestinal fluid were divided into two groups; one with vitamin supplementation during IVH and the other without vitamin supplementation. The blood vitamin status in patients without vitamin supplementation decreased gradually by the 4th week of IVH, while the other group with vitamin remained in normal range. However, the blood levels of vitamin A and E in this group showed gradual increase during IVH indicating that the dose of vitamin A and E should be reduced when IVH is prolonged. 2. To ascertain the vitamin status in patients with impaired liver function and excessive loss of intestinal fluid, blood levels of vitamins in four patients with congenital biliary atresia and one with high jejunostomy were measured during IVH. In patients with biliary atresia, the blood levels of fat soluble vitamins were low, although vitamins in standard dose had been given during IVH. A 3-month-old male with high jejunostomy developed vitamin D deficiency. This baby had been on IVH since his 2nd day of life. Bottle feeding was simultaneously carried out with IVH. At the age of 3 months, blood level of vitamin D was less than 5 ng/ml and bone x-ray of the extremities showed characteristic findings of vitamin D deficiency which was cured by increased vitamin D supplementation for 2 months. Our results indicate that it is important not only to include vitamins in the IVH solution, but to administer them in appropriate amount to prevent deficiency and intoxication.
日本小児外科学会の論文
1983-08-20

小児外科患児の経静脈栄養輸液におけるビタミン投与について

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