All patients evaluated by the hospital nutrition support service
(NSS) for initiation of TPN had nutritional assessments
that included the following laboratory measurements: serum
albumin, 24-h urinary creatinine, complete blood count with
red blood cell indices and serum iron (Fe), total iron binding
capacity (TIBC), ferritin (Ferr), and reticulocyte counts (Retic).
Those patients with Fe-to-TIBC ratio (or transferrin saturation
ITS]) of 10% or less were identified as iron deficient 7
and were randomized to receive no iron supplementation or 10
mg of iron as iron dextran in their daily TPN. Patients with a
history of reaction or allergy to iron dextran were excluded
from the study. Before initiation of iron supplements, verbal
consent was obtained from enrolled patients as per the condition of the institution review board study approval. Data were used
if the patients completed 7 d of TPN with or without iron.
Study patients had minimal oral intake and received no oral
iron supplements. All patients received TPN solutions containing
macronutrients of dextrose and amino acids with a goal
of providing 25 kcal/kg of body weight and 1.5 g/kg of amino
acids per estimated ideal body weight. Three-in-one admixtures
containing lipid were avoided because of concerns of emulsion
stability in TPN containing iron as a trivalent cation. 8 All TPN
solutions contained multivitamins and trace elements. Group 2,
the iron-supplemented group, received 10 mg of iron as iron
dextran (Infed, Schein Pharmaceuticals, Port Washington, NY)
in their TPN daily
All patients evaluated by the hospital nutrition support service
(NSS) for initiation of TPN had nutritional assessments
that included the following laboratory measurements: serum
albumin, 24-h urinary creatinine, complete blood count with
red blood cell indices and serum iron (Fe), total iron binding
capacity (TIBC), ferritin (Ferr), and reticulocyte counts (Retic).
Those patients with Fe-to-TIBC ratio (or transferrin saturation
ITS]) of 10% or less were identified as iron deficient 7
and were randomized to receive no iron supplementation or 10
mg of iron as iron dextran in their daily TPN. Patients with a
history of reaction or allergy to iron dextran were excluded
from the study. Before initiation of iron supplements, verbal
consent was obtained from enrolled patients as per the condition of the institution review board study approval. Data were used
if the patients completed 7 d of TPN with or without iron.
Study patients had minimal oral intake and received no oral
iron supplements. All patients received TPN solutions containing
macronutrients of dextrose and amino acids with a goal
of providing 25 kcal/kg of body weight and 1.5 g/kg of amino
acids per estimated ideal body weight. Three-in-one admixtures
containing lipid were avoided because of concerns of emulsion
stability in TPN containing iron as a trivalent cation. 8 All TPN
solutions contained multivitamins and trace elements. Group 2,
the iron-supplemented group, received 10 mg of iron as iron
dextran (Infed, Schein Pharmaceuticals, Port Washington, NY)
in their TPN daily
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