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Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities

Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and va...

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Autores principales: Dao, Duy T., Anez-Bustillos, Lorenzo, Cho, Bennet S., Li, Zhilling, Puder, Mark, Gura, Kathleen M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707657/
https://www.ncbi.nlm.nih.gov/pubmed/29143766
http://dx.doi.org/10.3390/nu9111185
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author Dao, Duy T.
Anez-Bustillos, Lorenzo
Cho, Bennet S.
Li, Zhilling
Puder, Mark
Gura, Kathleen M.
author_facet Dao, Duy T.
Anez-Bustillos, Lorenzo
Cho, Bennet S.
Li, Zhilling
Puder, Mark
Gura, Kathleen M.
author_sort Dao, Duy T.
collection PubMed
description Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard. Almost all micronutrients display a decrease in their serum levels in critically ill children, resulting in an increased risk of deficiency in this setting. While vitamin D deficiency is a well-known phenomenon in critical illness and can predict a higher need for intensive care, serum concentrations of many trace elements such as iron, zinc, and selenium decrease as a result of tissue redistribution in response to systemic inflammation. Despite a decrease in their levels, supplementation of micronutrients during times of severe illness has not demonstrated clear benefits in either survival advantage or reduction of adverse outcomes. For many micronutrients, the lack of large and randomized studies remains a major hindrance to critically evaluating their status and clinical significance.
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spelling pubmed-57076572017-12-05 Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities Dao, Duy T. Anez-Bustillos, Lorenzo Cho, Bennet S. Li, Zhilling Puder, Mark Gura, Kathleen M. Nutrients Review Micronutrients refer to a group of organic vitamins and inorganic trace elements that serve many functions in metabolism. Assessment of micronutrient status in critically ill children is challenging due to many complicating factors, such as evolving metabolic demands, immature organ function, and varying methods of feeding that affect nutritional dietary intake. Determination of micronutrient status, especially in children, usually relies on a combination of biomarkers, with only a few having been established as a gold standard. Almost all micronutrients display a decrease in their serum levels in critically ill children, resulting in an increased risk of deficiency in this setting. While vitamin D deficiency is a well-known phenomenon in critical illness and can predict a higher need for intensive care, serum concentrations of many trace elements such as iron, zinc, and selenium decrease as a result of tissue redistribution in response to systemic inflammation. Despite a decrease in their levels, supplementation of micronutrients during times of severe illness has not demonstrated clear benefits in either survival advantage or reduction of adverse outcomes. For many micronutrients, the lack of large and randomized studies remains a major hindrance to critically evaluating their status and clinical significance. MDPI 2017-10-28 /pmc/articles/PMC5707657/ /pubmed/29143766 http://dx.doi.org/10.3390/nu9111185 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Dao, Duy T.
Anez-Bustillos, Lorenzo
Cho, Bennet S.
Li, Zhilling
Puder, Mark
Gura, Kathleen M.
Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title_full Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title_fullStr Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title_full_unstemmed Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title_short Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities
title_sort assessment of micronutrient status in critically ill children: challenges and opportunities
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5707657/
https://www.ncbi.nlm.nih.gov/pubmed/29143766
http://dx.doi.org/10.3390/nu9111185
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