Abstract
Objective: We investigated deficiencies or excesses of vitamins B1, B6, and C, and folic acid in elderly patients who were nutritionally managed with total parenteral nutrition containing vitamins.
Methods: Subjects were elderly inpatients who required about 1000 mL of fluid managed by total parenteral nutrition (TPN). TPN solution (1000-1500 mL) was administered continuously for 24 hours. Blood samples were collected on the start day of follow-up and days 28, 56, and 84 to determine blood levels of vitamins B1, B6, and C, and folic acid.
Results: The results were obtained from 17 patients whose consents could be obtained from their families. The patients consisted of 6 men and 11 women, with an average age of 84.6 ± 6.4 (between 70 and 98 years). On the start day of follow-up, mean blood vitamin C levels were 3.7 ± 1.9 μg/mL, which were lower than the standard range (5.5-16.8 μg/mL). Mean blood vitamin C levels in the 6 patients who received additional 500 mg/day of vitamin C returned to the standard range (final values: 12.5 ± 3.1 μg/mL). Mean vitamin C levels in the 11 patients who did not receive vitamin C additionally remained low (final values: 3.5 ± 2.4 μg/mL). Mean blood vitamin B1 levels were slightly higher than the standard range. Mean blood vitamin B6 and mean blood folic acid levels remained within the standard range.
Discussion: Blood vitamin C levels were likely to decrease in elderly patients who needed TPN. Low levels of vitamin C were consistently observed in the patients who received 1000 to 1500 mL/day of TPN containing vitamins. These findings suggest the need for adequate supply of vitamin C by measuring blood vitamin C levels regularly in elderly patients who required TPN.
