CHAPTER 16: Selenium in Parenteral Nutrition

The essential nature of selenium in human health was established in the 1970s, with the description of clinical manifestations of deficiency in humans receiving Se-free parenteral nutrition (TPN) coinciding with the report of the association between Keshan disease and Se deficiency. Multiple reports of Se deficiency in patients receiving Se-free TPN have led to current recommendations to include Se routinely in TPN formulations. Parenteral Se is available as sodium selenite or selenious acid, either as part of a trace-element package or as a separate intravenous preparation. Guidelines for parenteral Se dosing have evolved over the past 40 years, with the goal to prevent deficiency and optimize health in the adult, pediatric and neonatal populations, with attention given to the altered metabolic requirements in disease states.