Zinc Deficiency Following Surgery in Zinc-Supplemented Infants

Total parenteral nutrition has become a mainstay in the management of infants following complicated abdominal surgery. As we have become sophisticated in our understanding of micronutrient nutrition, the term total parenteral nutrition has proved more a goal to be attained than a reality. In an effort to bypass the gastrointestinal tract and nurture critically ill postoperative patients intravenously, a new setting for the manifestation of deficiency states has emerged. This is illustrated by three infants who developed zinc deficiency during postoperative parenteral alimentation despite intravenous zinc supplementation (Fig 1). The pathogenesis of this syndrome and its complications are described, possible etiologies are considered, and recommendations for prevention and therapy are suggested.