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Trace element intakes should be revisited in burn nutrition protocols: A cohort study
- Source :
- Clinical Nutrition. 37:958-964
- Publication Year :
- 2018
- Publisher :
- Elsevier BV, 2018.
-
Abstract
- Due to inflammatory and hypermetabolic responses and to extensive exudative trace element (TEs) losses, major burn patients have substantially increased nutritional requirements. To date, information is only available for Cu, Se, and Zn. We aimed at analyzing losses of 12 TEs and Mg through burn wound exudation and corresponding plasma concentrations during the first week after burn injury, and to evaluate the impact of current TE repletion protocols.Burn wound exudate was collected under negative pressure in 15 adult patients burned 29 ± 20% of body surface (TBSA) for 8 days after injury. Two samples were collected daily. The TE concentrations were measured by inductively coupled plasma mass spectrometry (ICP-MS). Losses and serum concentrations were compared to intakes.For the majority of 12 TEs, the highest losses were observed on day 1, and declined thereafter. Despite Cu supplementation (4.23 mg/day) serum levels remained below reference values. Se supplements (745 μg/day) normalized and even increased serum levels to upper normal value. Despite large supplements (Zn 67.5 mg/day), serum Zn values remained below reference range. Large exudative losses of B, Br and Mg were found, as well as of Fe and I, with the latter being probably due to contamination.Current nutritional Cu, Se, Zn repletion protocols in major burn patients which were based on measured exudative losses should be revised to include higher Cu and lower Se doses, as well as planned Mg administration. In burns20% TBSA and for the other TEs the recommended parenteral nutrition TE doses appear sufficient.
- Subjects :
- Adult
Male
0301 basic medicine
Burn injury
medicine.medical_specialty
Nutritional Status
Reference range
Critical Care and Intensive Care Medicine
Cohort Studies
Young Adult
03 medical and health sciences
0302 clinical medicine
Animal science
Humans
Medicine
Prospective Studies
Prospective cohort study
Inductively coupled plasma mass spectrometry
Aged
Aged, 80 and over
030109 nutrition & dietetics
Nutrition and Dietetics
business.industry
Spectrophotometry, Atomic
Nutritional Requirements
Trace element
030208 emergency & critical care medicine
Middle Aged
Micronutrient
Trace Elements
Surgery
Parenteral nutrition
Dietary Supplements
Female
Burns
business
Total body surface area
Subjects
Details
- ISSN :
- 02615614
- Volume :
- 37
- Database :
- OpenAIRE
- Journal :
- Clinical Nutrition
- Accession number :
- edsair.doi.dedup.....f1d3f88d787ea342ab3a7db6a0d7d382