Routine addition of zinc to the parenteral fluid formula is not able to prevent zinc deficiency in all patients receiving parenteral nutrition

Abstract

Abstract Background Zinc deficiency is associated with poor wound healing, skin lesions, alopecia, etc. It is common in malnourished patients. Although parenteral nutrition (PN) has anabolic effect; however, lack of zinc supplement for a long period might result in zinc deficiency. The aim of the study is to calculate the incidence of zinc deficiency and the correlation to multiple nutritional parameters. Methods This is a retrospective analysis of patients who received PN and were under care of nutrition support service of Mackay Memorial Hospital from 1995 to 2020. Zinc serum level less than 800 μg/L were considered zinc deficiency. All patients had evaluation of nutrition status by assessing of albumin, total lymphocyte count (TLC), and midarm circumference (MAC). Results Data were analyzed by analysis of variance. A P value less than 0.05 was considered significant. A total of 3854 patients received PN during this period, 18 of them had zinc level less than 800 μg/L. In those 18 patients, 12 of them had clinical symptoms and signs of zinc deficiency. The average day of receiving PN for patients was 74.4 ± 62.5 (14–204) days. The average day of appearance of symptoms was 11 ± 12.3 (1–43) days. Eleven patients received blood or plasma transfusion during this period. It was found that serum zinc level did not correlate with serum albumin, TLC, and MAC. Conclusions Zinc deficiency could occur in patients with PN and adequate supply of calorie. It also occurs in patients with extra loss such as discharges from enterocutaneous fistula even in patients with supply of daily requirement of zinc. Zinc deficiency does not correlate with serum albumin, TLC, MAC, or age.