Impact of trace element supplementation on inflammatory response in postoperative patients with sepsis

doi:10.16139/j.1007-9610.2018.06.014

Abstract

Abstract: Objective To evaluate the impact of trace element in postoperative patients with sepsis on inflammatory response. Methods The postoperative patients with sepsis from August 2013 to July 2014 at intensive care unit in our hospital who need intravenous nutrition because of enteral nutrition in 72 hours less than 84 J(20 kal)/(kg·d) were inclu-ded. Concentrations of copper, zinc and iron in serum were detected with atomic absorption spectrophotometry on first day and tenth day. Relation of trace element concentrations to clinical and infection parameters was analyzed. A prospective randomized and controlled study was performed including 40 cases with only intravenous nutrition. Twenty cases were given 10 days of multiple-trace element intravenously 10 mL per day as group of multiple-trace element supplementation (MTES). Results There were 97 in 184 cases with sepsis who coincided with incision criteria enrolled in this study. At first day diagnosed as sepsis 62.89% of cases had iron deficient and 16.49% had zinc deficient. The concentrations of iron and zinc in serum related to APACHE Ⅱ scores negatively with correlation coefficient -0.284 and -0.297, respectively. Concentration of iron in serum related to the better sign time of treatment of infection and the duration of antibiotic treatment negatively (correlation coefficients -0.313 and -0.217, respectively). It was shown in prospective randomized and controlled study that procalcitatonin and C-reactive protein reduced significantly and concentration of serum copper, zinc and iron had trends of increase in MTES group. Concentration of C-reactive protein reduced significantly in MTES group when compared to control group (P=0.006) and fewer cases developed septic shock (25% vs 65%, P=0.011). Conclusions Lower concentrations of zinc and iron in serum were present in postoperative patients with sepsis which related to extent of severity and to the results in treatment of infection.

Key words: Trace element, Sepsis, Critically ill, Intensive care unit, Surgery

CLC Number:

LI Meiling, LI Lei, ZHANG ruyuan, LIU Jialin, QU Hongping. Impact of trace element supplementation on inflammatory response in postoperative patients with sepsis[J]. Journal of Surgery Concepts & Practice, 2018, 23(06): 533-538.

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