[Advances in the knowledge of the use of micronutrients in artificial nutrition]

Micronutrients are defined as those compounds necessary for the adequate physiological status of the organism and that may be administered through the daily diet either enteral or parenteral. The term micronutrient encompasses the vitamins and oligoelements, also termed trace elements. Vitamins cannot be synthesized by the organism and are categorized in two groups: water-soluble vitamins (the vitamin B group, C, folic acid, and biotin) and lipid-soluble vitamins (A, D, E, and K). Oligoelements are found in small amounts in the human body, and copper, cobalt, chrome, iron, iodine, manganese, molybdenum, nickel, selenium, and zinc are considered to be essential. The important role of micronutrients in critically-ill patients has been demonstrated, and their influence on the immune system, cancer, burnt, septic, and poly-traumatized patients has extensively been put in evidence. It is important to establish the micronutrients demands for each individual in order to achieve an adequate intake. However, there is little evidence on the necessary intake to achieve proper physiological functioning under different pathologies; therefore, studies bringing light to this situation are needed. The aim of this review is to update the current state of knowledge on micronutrients supplementation in the adult population with pathologies such as cancer, coronary and cardiovascular disease, bowel inflammatory disease, short-bowel syndrome, cystic fibrosis, liver disease, renal failure, respiratory failure, the surgical patient, big-burnt patient, pancreatitis, poly-traumatized patients, sepsis and HIV. After the bibliographical search, we describe the current state of knowledge regarding micronutrients intake in artificial nutrition under the above-mentioned pathologies.