Title

Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: An analysis of the supporting evidence

Date of this Version

4-2016

Document Type

Journal Article

Publication Details

Citation only

Baker, B., Ali, A.,& Isenring, L. (2016). Recommendations for manganese supplementation to adult patients receiving long-term home parenteral nutrition: An analysis of the supporting evidence. Nutrition in Clinical Practice, 31( 2 ), 180 - 185 . Access the journal

© Copyright, 2015 American Society for Parenteral and Enteral Nutrition

ISSN

0884-5336

Abstract

Introduction:

Manganese (Mn) toxicity is often observed in adult patients receiving long-term home parenteral nutrition (HPN), and differing recommendations on the safe level of Mn administration to these patients have been made in the literature over the past 10 years.

Methods:

This systematic review used the National Health and Medical Research Council (NHMRC) evidence hierarchy to assess the design and strength of individual studies (high I to low IV) and the overall grade of evidence (grade A high to grade D low).

Results:

Eight studies met the inclusion criteria. Levels of evidence ranged from high (NHMRC II) to mid-level (III-3). A widespread recommendation in the literature for patients receiving long-term HPN is 55 μg (1 μmol) Mn/d.

Conclusion:

The recommendation of 55 μg (1μmol) Mn/d is of moderate-strength evidence (NHMRC B grade). There is limited evidence to support not supplementing Mn to patients receiving long-term HPN. Further intervention studies providing high-level evidence (II and above) are required to determine the safety of not supplementing Mn to all patients receiving long-term HPN. (Nutr Clin Pract. 2016;31:180-185)

 

This document has been peer reviewed.