Document Detail


Micronutrients in the severely-injured patient.
MedLine Citation:
PMID:  10997673     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The trace element and vitamin requirements of severely-ill injured patients depend on a complex interaction of the status of the patient at the time of admission, ongoing losses and the potential benefit of supplying large amounts of individual micronutrients. Characteristic clinical deficiency states are now uncommon, but subclinical deficiency is of growing concern. The main effects of subclinical deficiency are: (1) an altered balance of reactive oxygen species and antioxidants, leading to oxidative damage of polyunsaturated fatty acids and nucleic acids, and possibly to increased activation of the transcription factor nuclear factor-kappaB, with increased production of pro-inflammatory cytokines: (2) impaired immune function with increased likelihood of infectious complications. Laboratory tests to optimize intake in such critically-ill patients lack sensitivity and specificity, this situation being made worse as a result of the acute-phase response. Recent studies have indicated the clinical benefit of providing large amounts of certain micronutrients in burned and head-injured patients. Further clinical studies are now required to define optimal levels of provision in different disease states, with a particular emphasis on markers of tissue function and clinical outcome.
Authors:
A Shenkin
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  The Proceedings of the Nutrition Society     Volume:  59     ISSN:  0029-6651     ISO Abbreviation:  Proc Nutr Soc     Publication Date:  2000 Aug 
Date Detail:
Created Date:  2000-12-06     Completed Date:  2001-03-01     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  7505881     Medline TA:  Proc Nutr Soc     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  451-6     Citation Subset:  IM    
Affiliation:
Department of Clinical Chemistry, University of Liverpool, UK. shenkin@liverpool.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Avitaminosis / diet therapy,  metabolism
Basal Metabolism
Humans
Micronutrients / deficiency,  metabolism*
Nutrition Assessment
Nutritional Requirements
Nutritional Status*
Oxidation-Reduction
Trace Elements / adverse effects,  deficiency*
Vitamins / administration & dosage
Wounds and Injuries / diet therapy,  metabolism*
Chemical
Reg. No./Substance:
0/Micronutrients; 0/Trace Elements; 0/Vitamins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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