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Nutr Clin Pract. 2016 Apr;31(2):180-5. doi: 10.1177/0884533615591600. Epub 2015 Jul 22.

Recommendations for Manganese Supplementation to Adult Patients Receiving Long-Term Home Parenteral Nutrition: An Analysis of the Supporting Evidence.

Author information

1
Centre for Dietetics Research, School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia bradley.baker@uqconnect.edu.au.
2
Princess Alexandra Hospital, Brisbane, Queensland, Australia.
3
Princess Alexandra Hospital, Brisbane, Queensland, Australia School of Human Movement Studies, University of Queensland, Brisbane, Queensland, Australia Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Queensland, Australia.

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 (1 µmol) 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.

KEYWORDS:

home parenteral nutrition; hypermanganesemia; manganese; micronutrients; trace elements

PMID:
26203074
DOI:
10.1177/0884533615591600
[Indexed for MEDLINE]

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