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Nutrients 2017, 9(11), 1185; doi:10.3390/nu9111185

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

1
Department of Surgery and Vascular Biology Program, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
2
Department of Pharmacy, Shanghai Children’s Hospital, Shanghai Jiao Tong University, 355 Luding Road, Shanghai 200062, China
3
Department of Pharmacy and the Division of Gastroenterology and Nutrition, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
The authors contributed equally to this manuscript.
*
Author to whom correspondence should be addressed.
Received: 27 September 2017 / Revised: 19 October 2017 / Accepted: 20 October 2017 / Published: 28 October 2017
(This article belongs to the Special Issue Nutritional Approach to Critically Ill Patients)
View Full-Text   |   Download PDF [340 KB, uploaded 31 October 2017]

Abstract

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. View Full-Text
Keywords: micronutrients; vitamins; minerals; critical illness; pediatric intensive care unit; neonatal intensive care unit micronutrients; vitamins; minerals; critical illness; pediatric intensive care unit; neonatal intensive care unit
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Dao, D.T.; Anez-Bustillos, L.; Cho, B.S.; Li, Z.; Puder, M.; Gura, K.M. Assessment of Micronutrient Status in Critically Ill Children: Challenges and Opportunities. Nutrients 2017, 9, 1185.

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