-
Journal of critical care · Apr 2014
Assessment of plasma and red cell trace element concentrations, disease severity, and outcome in patients with critical illness.
- Donald C McMillan, Fiona Stefanowicz, Rawia A Gashut, and Julia F Beulshausen.
- The Scottish Trace Element and Micronutrient Reference Laboratory, Department of Biochemistry, Royal Infirmary, Glasgow G31 2ER, UK.
- J Crit Care. 2014 Apr 1;29(2):214-8.
PurposeThe purpose of the study is to examine the value of both plasma and red cell trace element measurements when assessing nutritional status in patients with critical illness.Materials And MethodsA total of 125 patients who were admitted to intensive care unit with evidence of systemic inflammatory response as per Bone's criteria were recruited. Venous blood samples were obtained from all on admission and, in 31 of the 125 patients, on approximately days 4 and 7. Copper, zinc, and selenium concentrations were measured in plasma and erythrocytes and results related to mortality and patient outcome measures.ResultsA total of 125 critically ill patients were recruited; 81 (66%) were male, the median age was 60 (range, 18-100), and the medical/surgical proportion was 55/70 (44%/56%). The median (lower and upper 2.5th percentile) Acute Physiology and Chronic Health Evaluation II score, Sequential Organ Failure Assessment score, and length of stay and mortality were 21 (16-26), 7 (4-9) 3.7 days (1.5-11.1) and 19%, respectively. Plasma zinc and selenium concentrations were significantly lower on admission compared with reference intervals, whereas copper was increased. Normal plasma glutathione peroxidase activity suggested selenium status was adequate on admission; erythrocyte concentrations of glutathione peroxidase and trace elements were normal, suggesting adequate nutritional status 1 to 2 months before admission. Only plasma zinc and selenium were inversely associated with C-reactive protein (rs = -0.266, P = .004, rs = -0.322, P < .001, respectively). Compared with survivors, albumin (P < .001) concentrations were significantly lower in the nonsurvivor group. No significant difference of plasma selenium and zinc between survivors and nonsurvivors was found, although plasma selenium concentrations tended to be lower (P = .04). On multivariate logistic regression analysis of the significant variables, none was independently associated with mortality.ConclusionThe altered plasma concentrations of zinc, selenium, and copper in patients with critical illness were primarily due to the effects of the systemic inflammatory response and do not reliably indicate their status.Copyright © 2014 Elsevier Inc. All rights reserved.
Notes
Knowledge, pearl, summary or comment to share?You can also include formatting, links, images and footnotes in your notes
- Simple formatting can be added to notes, such as
*italics*
,_underline_
or**bold**
. - Superscript can be denoted by
<sup>text</sup>
and subscript<sub>text</sub>
. - Numbered or bulleted lists can be created using either numbered lines
1. 2. 3.
, hyphens-
or asterisks*
. - Links can be included with:
[my link to pubmed](http://pubmed.com)
- Images can be included with:
![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
- For footnotes use
[^1](This is a footnote.)
inline. - Or use an inline reference
[^1]
to refer to a longer footnote elseweher in the document[^1]: This is a long footnote.
.