<p>This IV infusion is accompanied by increased urinary excretion of the trace elements copper and, in particular zinc, which should be taken into account in the dosing of trace elements, particularly during long-term IV nutrition. Hyperphenylalaninemia has been noted in severely ill premature infants. In these patients, monitoring of the phenylalanine level is recommended and the infusion rate adjusted as needed. This should be used with caution in patients with diabetes mellitus, severe heart failure or with renal function in combination with fluid restrictions or oliguria/anuria of other origin. In patients with hyperglycemia, administration of exogenous insulin might be necessary.</p>