Survey on the use of zinc sulfate in parenteral nutrition in spanish hospitals

Cristina Crespo-Martínez, Mariola Sirvent-Ochando, Amparo Vázquez-Polo, Isabel Caba-Porras, Rosa M ª Romero-Jiménez, Pilar Tejada-González

In certain situations parenteral nutrition subsidiary patients may  have an increase in zinc demand (Zn). The objective of the study was to know  the scope of the use of Zn sulfate in patients with parenteral nutrition in Spanish hospitals. A survey was designed focusing on the incorporation of Zn sulfate into  parenteral nutrition, under real practice conditions, in the adult and pediatric  population. We asked about the number of parenteral nutrition supplemented  with zinc in the last year, by the doses used, and the situations in which it was  added to parenteral nutrition formula. The survey was conducted by telephone  interview to the pharmacists responsible for the parenteral nutrition units. A total of 53.9% (n = 69) of the contacted hospitals responded to the  survey. 60.9% incorporated Zn sulfate into the parenteral nutrition of adults,  and 76.2% used it in pediatric patients. In adults, 31.1% used Zn to complete  the dose provided by the solution of trace elements, 46.7% supplemented Zn in  patients with high intestinal losses, and 28.6% did it in critically ill patients with  a high degree of metabolic stress. The majority supplementation regimen was  10 mg/day (55.6%). In the pediatric population Zn ampules were used mainly in preterm infants, with the most used doses being 200 mcg/kg/day and 400  mcg/kg/day (42.6% and 23.4%, respectively). The use of zinc sulfate in adult parenteral nutrition to complete  the dosages suggests that solutions of trace elements could be deficient in Zn.  Its use as a supplement in adult parenteral nutrition is not an extended practice  in specialized nutritional support protocols in Spanish hospitals, highlighting its  low employment in patients with significant catabolism.