As you know, vitamins and trace elements are the micronutrients and vitamins are essential for growth and health because of the involvement in specific metabolic functions and vitamins cannot be synthesized in the body.
Therefore, they must be provided by diet or as a supplement and there are 13 vitamins are essential.
9 of those are water soluble and 4 lipid soluble.
15 trace elements play important physiologic roles, 9 of these trace elements are associated with deficiency states in humans and trace elements cannot be synthesized in the body as well. If not supported, their deficit should lead to functional abnormalities.
Cardiomyopathy, skeletal myopathy, muscle weakness, loss of pigmentation1
Reversible cardiomyopathy, muscle weakness, nail changes2
Reversible cardiomyopathy, muscle weakness, nail changes2
Skin lesions; other symptoms included alopecia, perioral ulcers, periungual lesions1
Severe skin lesions, diarrhea2
Lymphopenia, decreased T cell responses3
Vitamin B1 (thiamine)
Refractory lactic acidosis leading to death6
Confused state, mental sluggishness, horizontal nystagmus7
Vitamin B7 (biotin)
Dry eyes, angular cheilitis, hair loss4
Visual symptoms, signs of macular degeneration8
Prolonged prothrombin time9
1. Fessler TA. Nutr Clin Pract. 2013;28.722-729;
2. Misra S, et al. Nutrition in Clinical Practice. 2000;15:120-126;
4. Forbes GM, Et al. Nutrition. 1997;13:941-944;
6. CDC. Deaths associated with thiamine-deficient TPN. 1989;
7. Mirtallo JM. Nutr Clin Pract. 2015;30:86-91;
8. Biesalski HK. Gastroenterology. 2009;137:592-104;
9. Helphingstine CJ, et al. JPEN J Parenter Enteral Nutr. 2003;27:220-224.
The clinical consequences of micronutrient deficiency or toxicity in patients requiring parenteral nutrition therapy have been reported. In the literature, you can find about the trace elements or about vitamins in many guidelines or review articles (see the table footer above, and the references section at the end of the article).
CLINICAL CONDITION FOR HOSPITALIZATION
MICRONUTRIENTS THAT MAY BE AFFECTED BY CONDITION
Critical illness, including intensive care unit stay1-8
Chromium, copper, iron, molybdenum, selenium, zinc, vitamin A, vitamin B, vitamin C, vitamin E
Major trauma, including major burns1-5,7
Selenium, zinc, vitamin C
Hemodialysis, severe gastrointestinal losses, renal failure4-5,7
Selenium, zinc, vitamin A, vitamin B9
(folic acid), vitamin C, vitamin E
Zinc, vitamin A, vitamin C, vitamin E
1. Fessler TA, Nutr Clin Pract. 2013;28:722-729;
2. Hardy G, et al. Nutrition. 2009;25:1073-1084;
3. Shenkin A, S, Gastroenterology. 2009;137:561-69;
4. Agarwal A, et al. J Endocrinol Metab. 2011;1:57-63;
5. Berger MM. Gastroenterology. 2009;137:570-78;
6. Mirtallo JM. Nutr Clin Pract. 2015;30:86-91;
7. Sriram K, Lonchyna VA. JPEN J Parenter Enteral Nutr. 2009;33:548-562;
8. Strachan S. Current Anaesthesia & Critical Care. 2010;21:44-48.
In the short term, some conditions, such as critical illness, major trauma, renal failure, or surgery, may affect micronutrients. And, for example, in intensive care unit patients, requirements of some micronutrients may increase, decrease or no change.
The aggregated results of 15 trials in critically ill patients showed that antioxidant and trace elements supplementation was associated with a significant reduction in overall mortality.
And conditions also need to consider the decreased effect of drug therapy on micronutrient levels, especially on vitamins, for example, metformin and vitamin B12, methotrexate and folic acid. 
All guidelines recommend that daily parenteral vitamins and trace elements supplies should be provided to patients receiving parenteral nutrition in order to improve nutrition status and to prevent complications of deficiencies.
Short answer: not really!
A standard dosage of vitamins and trace elements is recommended because individual requirements cannot be easily determined.
As previously mentioned, supplementation of micronutrients is recommended by guidelines. However, in university hospitals or in intensive care units, supplementation of micronutrients is not provided up to 50% of the patients.
Several parenteral multivitamin and trace element formulations are available, and micronutrients should be added to parenteral nutrition solutions. However, enteral nutrition products already included micronutrients.
So, additional micronutrients are unnecessary if patients are receiving enteral nutrition unless higher doses are needed. To maximize stability, macronutrients are not included in commercially the available parenteral nutrition solutions they need to be added prior to infusion.
Vitamin stability is limited in the presence of air, light and some trace elements (TE)2
Vitamins and TE may be administered together5 assuming proper attention to:
Vitamin degradation may be caused by1:
Use of certain protections can help prevent vitamin degradation5
1. Allwood MC and Kearney MC. Nutrition 1998;14:697-706;
2. Muhlebach S, et al. Basics in Clin Nutr ESPEN 2011;373-392;
3. Gibbons E, Allwood, MC Neal T and Hardy G. J Pharm.Biomed Anal 2001;25:605-611;
4. Biesalski HK, et al. Ger Med Sci 2009;7:Dec21;
5. Such Diaz A, et al. Nutr Hosp 2009;1-9.
Most vitamins, especially vitamin A and vitamin B2, are the most sensitive vitamins to light. Vitamin C is the least stable vitamin and may be associated with substantial loads of storing/administration.
Certain protections such as light protection, using light protection bags, multi-layer bags and removal of excess air after filling can help to maintain stability and according to recent ESPEN guidelines published in 2020, addition of vitamins to parenteral nutrition admixtures should be immediately prior to infusion and separating infusion of micronutrients is also an alternative recommendation.
It’s usually unnecessary to routinely obtain certain levels of micronutrients. Levels of vitamin D, vitamin B, 12 and folate are the only ones easily available and of use in clinical practice, and obtaining serum levels of trace elements is even more difficult. Serum levels of trace elements may show recently administered trace elements and not tissue levels.
And parenteral nutrition may not contain expected levels of micronutrients due to contamination, instability, or compounding issues.
Since the deficiencies detected in the long term, guidelines generally recommended monitoring all signs and symptoms of the deficiencies.
As a summary: