Serum trace elements levels in patients transferred from the intensive care unit to wards

Trace elements act as co-factors and/or in co-enzymes in many metabolic pathways and its deficiency contributes to metabolic and infectious complications. The aim of this study was to determine serum zinc, selenium, cobalt, chromium, copper and ceruloplasmin levels for identify the need for post intensive care unit (ICU) nutritional follow-up.

This study was prospectively conducted in medical ICU. Adult patients (≥18 years) who stayed in ICU more than 48 h and transferred to ward were included in the study. Blood samples of trace element levels were sampled at discharge.

We enrolled 100 patients. The median age was 60 (40-70) years with Acute Physiology and Chronic Health Evaluation II (APACHE II) score 15 (11-21) . The median C-Reactive Protein (CRP) level was 53.9 (24.8-116.0) mg/L at discharge. Median serum zinc (24.4 mcg/dl:14.2-38.7) and chromium (0.22 mcg/dl:0.17-0.34) levels were below reference values, while median copper (111.9 (73.0-152.5) mcg/dl) and selenium (54.8 (36.4-95.25) mcg/L) values were within ranges. Serum concentrations of chromium, zinc, and selenium were lower than the normal values in 98, 90, and 36% of patients, respectively. The 28-day ICU mortality were correlated with low serum selenium levels (p = 0.03).

Serum chromium and zinc levels were below reference values at discharge, but this finding was in context of inflammation. Low serum selenium level observed in 36% was associated to 28-day ICU mortality.