Vitamin K is not a component of the multivitamin preparation added to parenteral nutrition solutions, and hospitalized patients receiving parenteral nutrition (PN) support are at risk of developing vitamin K deficiency. In this study, 70 consecutive patients receiving PN were followed prospectively to determine the incidence of a raised international normalized ratio (INR). Over a 3-week period, 20% of patients developed a raised INR compared with baseline. All elevations were mild, with no patients developing clinical bleeding. An alternative to routinely supplementing vitamin K is monitoring INR and supplementing those individuals with elevated coagulation parameters.
Get full access to this article
View all access options for this article.
References
1.
Food and Nutrition Board National Research Council: Fat soluble vitamins. IN Recommended Dietary Allowances. National Academy Press, Washington, DC, 1989, pp 107–114
2.
Lennon C, Davidson KW, Sadowski JA, et al: The vitamin K content of intravenous lipid emulsions. JPEN17:142–144, 1993
3.
Schepers GP, Dimitry AR, Eckhauser FE, et al: Efficacy and safety of low-dose intravenous versus intramuscular vitamin K in parenteral nutrition patients. JPEN12:174–177, 1988
4.
Dalton MJ, Schepers G, Gee JP, et al: Consultative total parenteral nutrition teams: The effect on the incidence of total parenteral nutrition-related complications. JPEN8:146–152, 1984
5.
Hands LJ, Royle GT, Kettlewell MG: Vitamin K requirements in patients receiving total parenteral nutrition. Br J Surg72:665–667, 1985
6.
Drittij RM, Sels JP, Rouflart M, et al: Vitamin K status and parenteral nutrition: The effect of Intralipid on plasma vitamin K, levels. Eur J Clin Nutr48:525–527, 1994
7.
Chambrier C, Leclercq M, Saudin F, et al: Is vitamin Kt supplementation necessary in long-term parenteral nutrition?JPEN22:87–90, 1998
8.
Binkley NC, Suttie JW: Vitamin K nutrition and osteoporosis. J Nutr125: 18121821, 1995
9.
Weber P: Management of osteoporosis: Is there a role for vitamin K?Int J Vit Nutr Res67:350–356, 1997
