Substitution of exudative trace element losses in burned children

Stucki, Pascal; Perez, Marie-Hélène; Cotting, Jacques; Shenkin, Alan; Berger, Mette M.

doi:10.1186/cc9198

Cited by 11 publications

(7 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…57,58 The adult doses, recalculated for body surface, were shown to be appropriate for burned children. 59 Some years later, the exudative losses were again measured with a new vacuum technique applied to the limbs, 60 confirming the previous study. Quality control was undertaken, and the IV doses were adapted.…”

Section: Micronutrientssupporting

confidence: 74%

Nutrition and Micronutrient Therapy in Critical Illness Should Be Individualized

Berger¹

2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

Critically ill (intensive care unit [ICU]) patients are characterized by organ failure, intense inflammatory response, insulin resistance, and altered metabolic response. The sicker the patient, the higher the threat to nutrition and micronutrient status. In addition, many patients start the ICU stay with an altered nutrition status, which requires assessment upon admission. Nutrition needs vary among patients as well as during hospitalization, as the metabolic response changes over time. Shock and acute organ failure result in a metabolic shift toward intense catabolism: endogenous glucose production aiming at ensuring the basal adenosine triphosphate production starts immediately and occurs at the expense of the lean body mass using amino acids for neoglucogenesis. Later, the stabilization and recovery phases are characterized by higher energy and substrate needs. Indirect calorimetry is the only tool enabling determination of the metabolic level. When and how should feeding be started? Recent research shows that the route does not matter much, with equipoise between enteral and parenteral nutrition (PN) as long as overfeeding is avoided. As micronutrients are an integral part of metabolism and antioxidant defenses, their delivery must be ensured: whereas needs are well defined for healthy individuals, needs for illness remain poorly defined. PN that contains only macrosubstrates requires the daily prescription of multimicronutrient complements to qualify as total PN. Achievement of goals requires minimal monitoring, consisting of the daily verification of energy and protein goal delivery achievement and daily follow-up determining blood glucose and phosphate levels and insulin requirements.

show abstract

Section: Micronutrientssupporting

confidence: 74%

Nutrition and Micronutrient Therapy in Critical Illness Should Be Individualized

Berger¹

2020

J Parenter Enteral Nutr

View full text Add to dashboard Cite

show abstract

“…19 All included studies were published between 1994 and 2014 and reported on at least one of the predefined primary and secondary outcome measures. 2,[17][18][19][25][26][27][28] Details of nutritional management, excluding intervention/control, were specified for all of the parenteral combined trace element supplementations studies 2,17,18,26,27,35 and omitted from both of the oral supplementation studies and oral vs oral and IV study. 19,25,28 Four of the included studies described their wound management/surgical management practices.…”

Section: Study Characteristicsmentioning

confidence: 99%

Trace Element Supplementation Following Severe Burn Injury

Kurmis

Greenwood

Aromataris

2016

Journal of Burn Care & Research

View full text Add to dashboard Cite

Trace elements have an important physiological role after severe burn injury with patients routinely receiving supplementation. Although commonly prescribed after burn injury, variation exists among supplement composition, frequency, and the dosage administered. This review aims to assess the effectiveness of trace element supplementation on clinically meaningful outcomes in patients who have sustained a severe burn injury. Supplementation of selenium, copper and zinc, either alone or combined, compared with placebo or standard treatment were eligible for inclusion. Predetermined primary outcome measures were mortality, length of stay, rate of wound healing, and complications. A comprehensive search strategy was undertaken. Methodological quality of eligible studies was appraised and relevant data extracted for meta-analysis. Eight studies met eligibility criteria for the review; four randomized controlled trials and four nonrandomized experimental trials, including a total of 398 participants with an age range of 6 to 67 years. Parenteral supplementation of combined trace elements was associated with a significant decrease in infectious episodes (weighted mean difference: -1.25 episodes, 95% confidence intervals: -1.70, -0.80; P < .00001). The results of this review indicate that the use of parentally administered combined trace elements after burn injury confer positive effects in decreasing infectious complications. Combined parenteral trace element supplementation and combined oral and parenteral zinc supplementation have potentially clinically significant findings on reducing length of stay. Oral zinc supplementation shows possible beneficial effects on mortality. Definitive studies are required to accurately define optimal trace element supplementation regimens, dosages, and routes after burn injury.

show abstract

“…Preliminary research suggests the benefit of micronutrient supplementation in children with burns, 5,14 although the available data is insufficient to make specific supplementation recommendations for this patient population at this time. Intervention studies in the pediatric population are limited, and study samples are too small to show conclusive results.…”

Section: Conclusion and Limitations Of The Evidencementioning

confidence: 94%

“…The authors concluded that pediatric patients may have much higher trace element requirements than adults. 14 Only one prospective, randomized, doubleblind, placebo-controlled trial on micronutrient supplementation in pediatric patients with burn injuries was found. 5 Barbosa et al 5 studied 32 pediatric patients with burns, 4.5 ± 4 years of age, with 8.8% to 22% TBSA burns.…”

Section: Topics In Clinical Nutrition/april-june 2013mentioning

confidence: 98%

“…The doses used in the adult trials were adjusted for total body surface area differences in children. 14 The developed protocol included providing all pediatric patients with burns admitted to the intensive care unit with a trace element solution containing 3.75 mg of Cu, 275 μg of Se, 37.5 mg of Zn, and 1200 mg of phosphate per 250 mL, administered at 250 mL/m 2 of the body surface area. A standard parenteral trace element solution was also provided to all subjects.…”

Section: Topics In Clinical Nutrition/april-june 2013mentioning

confidence: 99%

See 1 more Smart Citation

Micronutrient Requirements of Pediatric Patients With Burns

Козлова¹

2013

Topics in Clinical Nutrition

View full text Add to dashboard Cite

Deficiencies of vitamins C, D, and E, copper, selenium, and zinc in patients with burns are related to poor clinical outcomes. The physiology of the deficiencies is likely multifactorial, with tissue catabolism, hormone response, oxidative stress, hypoalbuminemia, wound losses, and medications being contributors. Micronutrient supplementation in patients with burns has theoretical benefits and is administered to adults in intensive care units. However, limited data exist for children with burns. This review focuses on evidence of micronutrient deficiencies and increased micronutrient requirements in pediatric patients with burns, discusses intervention studies and supplementation guidelines for pediatric and adult patients, and explores the gaps in current research.

show abstract

Substitution of exudative trace element losses in burned children

Cited by 11 publications

References 5 publications

Nutrition and Micronutrient Therapy in Critical Illness Should Be Individualized

Nutrition and Micronutrient Therapy in Critical Illness Should Be Individualized

Trace Element Supplementation Following Severe Burn Injury

Micronutrient Requirements of Pediatric Patients With Burns

Contact Info

Product

Resources

About