Parenteral administration of trace elements to critically ill patients

Area of Science:

• Critical care medicine
• Trace element metabolism
• Nutritional biochemistry

Background:

• Intensive care unit (ICU) patients often experience altered nutrient metabolism.
• Accurate assessment of mineral balance is crucial for optimizing nutritional support in critically ill individuals.

Purpose of the Study:

• To evaluate the balance of essential trace elements (zinc, copper, manganese, chromium, selenium, molybdenum, and nickel) in patients admitted to an intensive care unit.
• To determine if current recommended intake levels ensure positive or neutral mineral balance in this population.

Main Methods:

• Balance studies were conducted over seven days in eight ICU patients.
• Daily intake and losses (urine, gastrointestinal) of selected minerals were measured.
• Atomic absorption spectrometry was used for elemental analysis.
• Cumulative balances for each mineral were calculated.

Main Results:

• Positive balances were achieved for zinc, copper, and manganese when administered amounts met current recommendations.
• Chromium balances were inconsistent across patients.
• Most patients exhibited negative balances for selenium, molybdenum, and nickel.
• Abnormal renal and gastrointestinal function in critically ill patients complicated balance interpretation.

Conclusions:

• Current recommended intakes may be insufficient for maintaining adequate balances of selenium, molybdenum, and nickel in ICU patients.
• Trace element balance studies in critically ill patients are challenging due to physiological derangements.
• Further research is needed to establish optimal trace element requirements for intensive care settings.