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

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 va...

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Bibliographic Details
Published in:	Nutrients Vol. 9; no. 11; p. 1185
Main Authors:	Dao, Duy T, Anez-Bustillos, Lorenzo, Cho, Bennet S, Li, Zhilling, Puder, Mark, Gura, Kathleen M
Format:	Journal Article
Language:	English
Published:	Switzerland MDPI AG 28-10-2017 MDPI
Subjects:	Child Child Nutrition Disorders - blood Child Nutrition Disorders - diagnosis Child Nutrition Disorders - physiopathology Child Nutrition Disorders - therapy Child Nutritional Physiological Phenomena Child, Preschool Children critical illness Critical Illness - therapy Deficiency Diseases - blood Deficiency Diseases - diagnosis Deficiency Diseases - physiopathology Deficiency Diseases - therapy Dietary intake Dietary Supplements - adverse effects Humans Infant Infant Nutrition Disorders - blood Infant Nutrition Disorders - diagnosis Infant Nutrition Disorders - physiopathology Infant Nutrition Disorders - therapy Infant Nutritional Physiological Phenomena Infant, Newborn Iron Metabolism Micronutrients Micronutrients - administration & dosage Micronutrients - adverse effects Micronutrients - blood Micronutrients - deficiency minerals neonatal intensive care unit Nutrient deficiency Nutrition Assessment Nutritional Status pediatric intensive care unit Predictive Value of Tests Review Risk Factors Selenium Serum levels Trace elements Treatment Outcome Vitamin D Vitamins Zinc pediatric intensive care unit minerals micronutrients vitamins critical illness neonatal intensive care unit
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Summary:	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.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-3 content type line 23 ObjectType-Review-1 The authors contributed equally to this manuscript.
ISSN:	2072-6643 2072-6643
DOI:	10.3390/nu9111185