Serum Vitamin K Concentration in Pediatric Patients Receiving Total Parenteral Nutrition

Abstract

The only multivitamin preparation for total parenteral nutrition currently available in the United States that contains vitamin K is the pediatric formulation MVI-Pediatric. The recommended dose provides 200 μg of vitamin K ₁ per day to term infants and children up to 11 years old. This dose is well above the recommended dietary allowance of approximately 1 μg/kg per day, but the losses of vitamin K during administration are unknown. We evaluated the stability of vitamin K₁ in a standard total parenteral nutrition infusion and found that on average 72.7 ± 4.9% of the original vitamin K₁ was present after 24 hours. By using high-performance liquid chromatography with electrochemical reduction and fluorescence detection, we obtained the serum vitamin K₁ concentrations in 11 pediatric patients receiving total parenteral nutrition with MVI-Pediatric (Rorer Pharmaceuticals, Fort Washington, PA) supplementation and in control children. The serum vitamin K₁ concentration (19.3 ± 12.2 ng/mL) in patients receiving MVI-Pediatric is significantly higher than that in control children 1.9 ± 1.5 ng/mL (p < .001). Current practice results in excessive levels of vitamin K in pediatric patients. (Journal of Parenteral and Enteral Nutrition 17:465-467, 1993)