Sunday October 30, 2005
Back to Basics - essential trace elements
Importance of seven essential trace elements is relatively way higher in ICUs due to hypermetabolic state of patients. Being an intensivist it is important to have some know how of them. Except for iron and iodine all others need to be provided with enteral and parentral formulae to satisfy atleast their RDA.
1. Iron: in ICU merely checking Fe level may not give real answer of its deficiency. Always check Ferritin level (below 18 indicates deficiency).
2. Selenium: important anti-oxidant and unfortunately many times not included in available enteral/parentral formulae.
3. Chromium: necessary for normal glucose utilization.
4. Copper: essential for formation of hemoglobin.
5. Iodine: needed for proper thyroid metabolism.
6. Manganese: part of Ca+/phos+ metabolism.
7. Zinc: needed for proper wound healing.
Refrences: Click to get abstract/article.
1. Trace minerals in ICU patients: a forgotten cause of delayed recovery? - Critical Care 2004, 8(Suppl 1):P264
2. Trace element supplementation modulates pulmonary infection rates after major burns: American Journal of Clinical Nutrition, Vol 68, 365-371
3. Levels of oligo-elements and trace elements in patients at the time of admission in intensive care units - Nutr Hosp. 1990 Sep-Oct;5(5):338-44.
4.Canadian clinical practice guidelines for nutrition support in mechanically ventilated, critically ill adult patients - Journal of Parenteral and Enteral Nutrition, Vol 27, Issue 5, 355-373
5. EARLY ENTERAL SUPPLEMENTATION WITH PHARMACONUTRIENTS IN CRITICALLY ILL PATIENTS - Critical Care Medicine: Volume 32(12) Supplement December 2004 p A4