Vitamin Regimens in Parenteral Nutrition: A Dilemma

Recently, a parenteral vitamin product which matches the recommended dietary allowance for parenteral vitamins set forth by the Nutrition Advisory Group (NAG) of the American Medical Association has been marketed. The release of this product calls attention once again to the NAG recommendations and their applicability. The authors point out that the NAG guidelines do not address the needs of the traumatized or hypermetagolic patient. Further, the cost of the new vitamin product is questioned in regard to the additional expense incurred in attempting to administer vitamins as per the NAG recommendations. The authors offer cost and therapeutic comparisons of existing produces on the market to the new vitamin product, and explain a therapeutic regimen utilizing multiple products administered on regular basis compared to the daily administration of the new product. The weekly cost of the plan proposed by the authors is +7.56 compared to +16.70 per week for the new vitamin product.