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Multiple vitamin k


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To whom we must give repetetive vitamin k : to which gestational week, limited to taking total parenteral nutrition, limited to taking antibiotics ? When we must give : once a  week ? Until which gestational age ?

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I'm not really sure what you are looking for here, but for ILFAD patients with intestinal failure we sometimes give oral vitamin-K 1 mg/kg/day. Otherwise vitamin K is supplemented in our fortification-formula (we use nutricias Nutriprem with Vitamine K 4mg/g), even though I saw a case report on HM-formula leading to vitamin-k deficiency ( https://pubmed.ncbi.nlm.nih.gov/37981048/ ). 

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In patients taking parenteral nutritition once a week  vitamin k injections are part of treatment.

Are there any other indications for prematures, patients' taking antibiotics ?

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Could you please evolve, what would be the reason to supplement vitamin-K in patients taking antibiotics? Every neonate gets an intramuscular or intravenous (if i.m. is inappropriate) vitamin-K injection at birth. Full dose 1 mg if the weight is over 1500g, otherwise 0,5 mg. It should be sufficient, or is it something we would need to consider in regards to the infection?


We give Numeta as parenteral nutrition, and add Vitalipid infant for fat soluble vitamines, it contains 0,02 mg/ml phytomenadione. Most preemies are introduced to enteral nutrition very early on, and with fortification when oral intake exceeds 70 ml/Kg/day. For longer treatment durations our guidelines recommends controlling for PK once a week if there is signs of liver failure, or if parenteral nutrition longer than 4 weeks (along with many other tests like transaminases, bili+konj bilim, albumin, magnesium, cobolamin, tokoferol etc. ). 

 

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At birth, we give vitamin K once per day for 3 days since we received a case who died from bleeding from vitamin K deficiency despite receiving his shot at birth. Later on, it depends on a case-by-case evaluation( long-term parenteral nutrition, bleeding tests disturbed, etc...)  We also try to get to oral ( through an NG tube) very quickly. 

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