Document Detail


Baseline serum concentrations of zinc, selenium, and prolactin in critically ill children.
MedLine Citation:
PMID:  23392368     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To describe serum concentrations of zinc, selenium, and prolactin in critically ill children within 72 hours of PICU admission, and to investigate relationships between these immunomodulators and lymphopenia.
DESIGN: An analysis of baseline data collected as part of the multicenter Critical Illness Stress Induced Immune Suppression (CRISIS) Prevention Trial.
SETTING: PICUs affiliated with the Collaborative Pediatric Critical Care Research Network.
PATIENTS: All children enrolled in the CRISIS Prevention Trial that had baseline serum samples available for analysis.
INTERVENTIONS: None.
MEASUREMENTS AND MAIN RESULTS: Of 293 critically ill children enrolled in the CRISIS Prevention Trial, 284 had baseline serum samples analyzed for prolactin concentration, 280 for zinc concentration, and 278 for selenium concentration within 72 hours of PICU admission. Lymphocyte counts were available for 235 children. Zinc levels ranged from nondetectable (< 0.1 μg/mL) to 2.87 μg/mL (mean 0.46 μg/mL and median 0.44 μg/mL) and were below the normal reference range for 235 (83.9%) children. Selenium levels ranged from 26 to 145 ng/mL (mean 75.4 ng/mL and median 74.5 ng/mL) and were below the normal range for 156 (56.1%) children. Prolactin levels ranged from nondetectable (< 1 ng/mL) to 88 ng/mL (mean 12.2 ng/mL and median 10 ng/mL). Hypoprolactinemia was present in 68 (23.9%) children. Lymphopenia was more likely in children with zinc levels below normal than those with zinc levels within or above the normal range (82 of 193 [42.5%] vs. 10 of 39 [25.6%], p = 0.0498). Neither selenium nor prolactin concentrations were associated with lymphopenia (p = 1.0 and p = 0.72, respectively).
CONCLUSIONS: Serum concentrations of zinc, selenium, and prolactin are often low in critically ill children early after PICU admission. Low serum zinc levels are associated with lymphopenia, whereas low selenium and prolactin levels are not. The implications of these findings and the mechanisms by which they occur merit further study.
Authors:
Sabrina M Heidemann; Richard Holubkov; Kathleen L Meert; J Michael Dean; John Berger; Michael Bell; K J S Anand; Jerry Zimmerman; Christopher J L Newth; Rick Harrison; Douglas F Willson; Carol Nicholson; Joseph Carcillo;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies     Volume:  14     ISSN:  1529-7535     ISO Abbreviation:  Pediatr Crit Care Med     Publication Date:  2013 May 
Date Detail:
Created Date:  2013-05-07     Completed Date:  2014-03-03     Revised Date:  2014-04-17    
Medline Journal Info:
Nlm Unique ID:  100954653     Medline TA:  Pediatr Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  e202-6     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Child
Child, Preschool
Critical Illness*
Female
Humans
Infant
Intensive Care
Lymphocyte Count
Lymphopenia / blood,  immunology
Male
Patient Admission
Prolactin / blood*
Selenium / blood*
Severity of Illness Index
Time Factors
Zinc / blood*
Grant Support
ID/Acronym/Agency:
U01 HD049934/HD/NICHD NIH HHS; U01HD049934/HD/NICHD NIH HHS; U10 HD049945/HD/NICHD NIH HHS; U10 HD049981/HD/NICHD NIH HHS; U10 HD049983/HD/NICHD NIH HHS; U10 HD050012/HD/NICHD NIH HHS; U10 HD050096/HD/NICHD NIH HHS; U10HD049945/HD/NICHD NIH HHS; U10HD049981/HD/NICHD NIH HHS; U10HD049983/HD/NICHD NIH HHS; U10HD050012/HD/NICHD NIH HHS; U10HD050096/HD/NICHD NIH HHS; U10HD500009/HD/NICHD NIH HHS; UL1 TR000005/TR/NCATS NIH HHS
Chemical
Reg. No./Substance:
9002-62-4/Prolactin; H6241UJ22B/Selenium; J41CSQ7QDS/Zinc
Comments/Corrections
Comment In:
Pediatr Crit Care Med. 2013 May;14(4):443-5   [PMID:  23648879 ]
Pediatr Crit Care Med. 2013 Jul;14(6):655   [PMID:  23823206 ]
Pediatr Crit Care Med. 2013 Jul;14(6):654   [PMID:  23823205 ]

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