1. Multiple Micronutrient Plasma Level Changes Are Related to Oxidative Stress Intensity in Critically Ill Children
- Author
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Charlotte Cuerq, Marion Pitance, Etienne Javouhey, Emilie Blond, Amandine Bellon, Tiphanie Ginhoux, Sylvain Roche, Aurélie Portefaix, Jenna Ridout, Carole Ford-Chessel, Muriel Bost, René Ecochard, Frédéric V. Valla, Hospices Civils de Lyon (HCL), Catalan Institute of Nanoscience and Nanotechnology (ICN2), Consejo Superior de Investigaciones Científicas [Madrid] (CSIC)-Barcelona Institute of Science and Technology (BIST), Institució Catalana de Recerca i Estudis Avançats (ICREA), Cardiovasculaire, métabolisme, diabétologie et nutrition (CarMeN), Institut National de la Recherche Agronomique (INRA)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Université de Lyon-Institut National des Sciences Appliquées (INSA)-Institut National des Sciences Appliquées (INSA)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Hospices Civils de Lyon (HCL), Biostatistiques santé, Département biostatistiques et modélisation pour la santé et l'environnement [LBBE], Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS)-Laboratoire de Biométrie et Biologie Evolutive - UMR 5558 (LBBE), Université de Lyon-Université de Lyon-Institut National de Recherche en Informatique et en Automatique (Inria)-VetAgro Sup - Institut national d'enseignement supérieur et de recherche en alimentation, santé animale, sciences agronomiques et de l'environnement (VAS)-Centre National de la Recherche Scientifique (CNRS), Institut de Biologie du Développement de Marseille (IBDM), Aix Marseille Université (AMU)-Collège de France (CdF (institution))-Centre National de la Recherche Scientifique (CNRS), Division of Pediatric Intensive Care, Hôpital Femme Mère Enfant, Laboratoire de Mécanique des Systèmes et des Procédés (LMSP), Centre National de la Recherche Scientifique (CNRS), Consejo Superior de Investigaciones Científicas [Spain] (CSIC)-Barcelona Institute of Science and Technology (BIST), Aix Marseille Université (AMU)-Collège de France (CdF)-Centre National de la Recherche Scientifique (CNRS), Hôpital Femme Mère Enfant [CHU - HCL] (HFME), Department of Biochemistry, Lyon Sud Hospital, Laboratoire d'Analyse de Traces et Métaux Toxiques, hospices civils de Lyon, Service de Biostatistique, Université de Lyon, Paediatric Intensive Care Unit, Addensbrooke's Hospital, EPICIME-CIC 1407 de Lyon, Inserm, Service de Pharmacologie Clinique, CHU-Lyon, Department of Pediatric Anestesiology, Hôpital Femme Mère Enfant, Hospices Civils de Lyon, Service diététique, Unité Mixte de Recherche Epidémiologique et de Surveillance Transport Travail Environnement (UMRESTTE UMR_T9405), Université de Lyon-Université de Lyon-Université Gustave Eiffel (UNIV GUSTAVE EIFFEL), Hospices Civils de Lyon (HCL)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Institut National des Sciences Appliquées de Lyon (INSA Lyon), Institut National des Sciences Appliquées (INSA)-Université de Lyon-Institut National des Sciences Appliquées (INSA)-Université de Lyon-Université Claude Bernard Lyon 1 (UCBL), Université de Lyon-Institut National de la Recherche Agronomique (INRA), and Université de Lyon-Université de Lyon-Université Gustave Eiffel
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Male ,Micronutrient deficiency ,medicine.medical_treatment ,[SDV]Life Sciences [q-bio] ,vitamin C ,vitamin E ,Critical Care and Intensive Care Medicine ,medicine.disease_cause ,Severity of Illness Index ,Pediatrics ,clinical-trial ,chemistry.chemical_compound ,0302 clinical medicine ,SANTE ,030212 general & internal medicine ,Micronutrients ,Prospective Studies ,Child ,selenium ,2. Zero hunger ,chemistry.chemical_classification ,pediatric critical illness ,Glutathione peroxidase ,zinc ,Micronutrient ,3. Good health ,Child, Preschool ,controlled-trial ,Female ,Vitamin ,medicine.medical_specialty ,EPIDEMIOLOGIE ,Adolescent ,Critical Illness ,critical-care medicine ,antioxidant status ,CAROTENE ,03 medical and health sciences ,support therapy ,Internal medicine ,General & Internal Medicine ,medicine ,Humans ,enteral nutrition ,carotene ,Vitamin C ,business.industry ,Vitamin E ,Infant ,030208 emergency & critical care medicine ,medicine.disease ,Malnutrition ,Oxidative Stress ,Cross-Sectional Studies ,american ,society ,chemistry ,Case-Control Studies ,copper ,Pediatrics, Perinatology and Child Health ,[SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie ,inflammatory response syndrome ,patient society ,business ,Oxidative stress ,Biomarkers - Abstract
Objectives: Micronutrient supplementation in critically ill adults remains controversial. In the pediatric setting, the impact of oxidative stress on the overall micronutrient status has been poorly explored, due to the limited number of studies and to confounding factors (i.e., malnutrition or extra losses). In order to better understand this phenomenon, we aim to describe micronutrient status, focusing on seven micronutrients, in well-nourished critically ill children presenting with severe oxidative stress. Design: Prospective, transversal, observational, single-center study. Setting: PICU, and anesthesiology department, Lyon, France. Patients: Three groups of patients were clinically defined: severe oxidative stress PICU group (at least two organ dysfunctions), moderate oxidative stress PICU group (single organ dysfunction), and healthy control group (prior to elective surgery); oxidative stress intensity was controlled by measuring plasma levels of glutathione peroxidase and glutathione. Children presenting any former condition leading to micronutrient deficiency were excluded (malnutrition, external losses). Interventions: Plasma levels of selenium, zinc, copper, vitamin A, vitamin E, vitamin C, and -carotene were measured in PICU oxidative stress conditions and compared with those of healthy children. Measurements and Main Results: Two hundred one patients were enrolled (51, 48, and 102 in severe, moderate, and healthy control groups, respectively). Median age was 7.1 years (interquartile range, 2.1-13.8 yr). There was a significant trend (p \textless 0.02) toward plasma level decrease of six micronutrients (selenium, zinc, copper, vitamin E, vitamin C, and -carotene) while oxidative stress intensity increased. Biological markers of oxidative stress (glutathione peroxidase and glutathione) were in accordance with the clinical definition of the three groups. Conclusions: A multiple micronutrient deficiency or redistribution occurs in critically ill children presenting with severe oxidative stress. These findings will help to better identify children who might benefit from micronutrient supplementation and to design adapted supplementation trials in this particular setting.
- Published
- 2018
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