Trace elements - Commentary

摘要

This is a timely review, documenting the important subject of trace element measurement and replacement in the critically ill population. As stated in this review, they are rarely considered in the day-to-day management of the critically ill patient. Trace elements are essential nutrients with a large range of functions. Deficiencies do occur, not only because of pre-morbid chronically low levels but also due to increased losses through the gut, urine and skin during critical illness. Trace element deficiencies appear to be most severe in those patients who suffer major burn injuries where losses of trace elements through burn wound exudate are significant These may delay wound healing, which together with graft failure is a major issue after a burn injury. In this particular group of patients it may not only just be necessary to meet normal trace element requirements, but it is also possible that in large burns, pharmacological manipulation (i.e. to above recommended daily requirements) may have some morbidity and mortality benefit.