Anzeige
Erschienen in:
11.10.2017 | What's New in Intensive Care
What’s new in trace elements?
Erschienen in: Intensive Care Medicine | Ausgabe 5/2018
Einloggen, um Zugang zu erhaltenExcerpt
Trace elements (TE), namely selenium (Se), zinc (Zn), copper (Cu), iodine (I), molybdenum (Mo), chromium (Cr), iron (Fe), and manganese (Mn), are essential in daily nutritional care of the critically ill [1] and should be administered daily (normal values are presented in Table 1). Their deficiency may be lethal if uncorrected. Because of their potential antioxidant functions [2], TE have been administered alone or in association, sometimes at high doses, in specific critical conditions, to improve outcome. Special conditions such as burns, fistulas, or renal replacement therapy involve large losses and have specific requirements. Special needs/utilization of TE are discussed.
Table 1
Plasma level of Se (selenium), Zn (zinc), Cu (copper), and Fe (iron) in various clinical conditions and their known association with outcome
|
Conditions
|
Se
|
Zn
|
Cu
|
Fe
|
Outcome if administrated and references
|
|---|---|---|---|---|---|
|
RDI
|
60 μg
|
8–10 mg
|
1 mg
|
0.5 mg
|
RDI
|
|
Sepsis
|
Low
|
Decrease
|
Low
|
− [3]
|
|
|
Burns
|
Low
|
Low +++
|
Low ++
|
Low
|
+ [12]
|
|
AKI/CRRT
|
Low
|
Decrease
|
Low
|
+ [11]
|
|
|
Cardiovascular
|
Decrease after surgery
Check if severe CHF
|
Decrease after surgery
|
Decrease after surgery
|
− [6]
|
|
|
Liver failure
|
Do not administer Cu
|
||||
|
Bariatric surgery
|
37% of patients decrease
|
10% of patients decrease
|
5–42% low
|
+ [14]
|