Micronutrient Supplementation for Critically Ill Adults: Practical Application View Full Text


Ontology type: schema:Chapter     


Chapter Info

DATE

2015

AUTHORS

Janicke Visser , Renée Blaauw

ABSTRACT

Critical illness is associated with oxidative stress and low levels of most micronutrients, with resultant compromised antioxidant defenses. Micronutrient supplementation is thought to be beneficial to critically ill patients by ameliorating oxidative stress and by improving clinical outcomes. The current evidence base suggests potential benefit of micronutrient (specifically antioxidant) supplementation in critically ill adults in terms of defined clinical outcomes (notably a decrease in mortality, shorter mechanical ventilation, and possibly a reduction in infectious complications). A combination of supplemental vitamins and trace elements (including selenium) should be considered in critically ill patients. The current evidence suggests that timing (as early as possible), sufficient duration, and dosing are key factors to ensure optimal clinical benefit. Micronutrients should be provided at, at least, the current available recommended doses to prevent clinical deficiencies. For further possible benefit, clinicians should consult the guidelines from professional nutrition societies and the higher micronutrient dosages as employed in the various trials (in the clinical settings studied). Furthermore, clinicians will be well served by keeping the bigger picture in mind, within the settings of the complexity of the acute phase response and the heterogeneity of the critical care population. In this fast-evolving field, the definition of optimal nutrition therapy should include all relevant components (including micronutrients) in the right combination and doses, to the right patients, and at the right time to ensure optimal clinical benefit and outcome. More... »

PAGES

445-458

Book

TITLE

Diet and Nutrition in Critical Care

ISBN

978-1-4614-7837-9
978-1-4614-7836-2

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/978-1-4614-7836-2_78

DOI

http://dx.doi.org/10.1007/978-1-4614-7836-2_78

DIMENSIONS

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