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Trace elements in critical states. Part 1: zinc and iron


Authors: A. Kazda;  H. Brodská
Authors‘ workplace: Ústav lékařské biochemie a laboratorní diagnostiky 1. LF UK a VFN Praha
Published in: Klin. Biochem. Metab., 21 (42), 2013, No. 4, p. 197-202

Overview

The problems of trace elements (TE) metabolism and of their supplementation in critically ill patients are different from metabolism and optimal daily intake under physiological conditions or during less dangerous diseases. Critically ill patients may to lose unmeasurable amount of these elements by gastric suction, by drain or fistula content, by bleeding or blood sampling. On the other side they receive unmeasurable amounts of TE thanks to contamination of infusions, solutions of parenteral nutrition or through the transfusions or supplementation of albumin. TE have the key significance for the alleviation of the oxidative stress. With regard to critical states most often are discussed zinc, iron, copper and selenium.

Part 1. of our paper is dedicated to zinc and iron. Thanks to interleukins, in reaction to trauma and infection these TE are redistributed from plasma into tissues. This is comprehended as efforts to eliminate from the circulation elements supporting the microbial growth. With respect to the significance of zinc for the synthesis of proteins and of iron for the erythropoiesis more clinical trials were realized with supplementation of these TE in higher amounts as generally recommended. Nevertheless till today the experimental, as well as clinical, studies and reviews are often finished with warning before high dosing in critical states.

In the paper are also discussed the complications of abundant intake of both TE. The toxic effects of zinc and iron overdose, which can cause a critical condition per se, are mentioned.

Keywords:
zinc, iron, trauma, systemic inflammation, critical state.


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