Hostname: page-component-7c8c6479df-hgkh8 Total loading time: 0 Render date: 2024-03-28T23:22:21.708Z Has data issue: false hasContentIssue false

Zn2+-deficiency in critically ill patients with SIRS is linked to Mg and oxidative status

Published online by Cambridge University Press:  04 June 2010

E. Planells
Affiliation:
Physiology, University of Granada, Spain
D. Florea
Affiliation:
Physiology, University of Granada, Spain
M. García-Ávila
Affiliation:
Physiology, University of Granada, Spain
E. Millán
Affiliation:
Physiology, University of Granada, Spain
L. Sáez
Affiliation:
Physiology, University of Granada, Spain
M. Rodriguez-Elvira
Affiliation:
icu & ndu, Hvn. Sas. Spain
B. Quintero
Affiliation:
Physico-Chemistry, University of Granada, Spain
C. Soler
Affiliation:
Consejeria De Educación, Granada, Spain
C. Cabeza
Affiliation:
Physico-Chemistry, University of Granada, Spain
F. Gonzalez-Diaz
Affiliation:
Physiology, University of Granada, Spain
González-Martín
Affiliation:
Physiology, University of Granada, Spain
P. Aranda
Affiliation:
Physiology, University of Granada, Spain
Rights & Permissions [Opens in a new window]

Abstract

Type
Abstract
Copyright
Copyright © The Authors 2009

Zn deficiency and Mg deficiency are linked to inflammatory and immune processes mediated by reactive oxygen species that are increased in those lacking circumstances. Measurement and monitoring of Zn2+ are important to prevent the development of serious and potentially fatal complications in critically ill patients. The aim of this study was to define the status of Zn2+ at admission and 7 days of ICU stay in critically ill patients and to evaluate its relationship with Mg2+ and Cu2+ in plasma and erythrocyte, and with oxidative status.

A prospective study was done on 38 critically ill consecutive patients with inclusion criteria: ≥18 years old, APACHE II >15 and SIRS diagnostic. Zn2+, Cu2+ and Mg2+ were measured by flame atomic absorption spectrophotometry (AAS) in wet-mineralised samples of plasma and erythrocyte. Mg, Zn and Cu content in administered nutrition was recorded daily during the 7 days of studied stay, and % RDIs were obtained. SOD activity was measured by spectrophotometry with an enzymatic method in erythrocyte. TNF-β, IL-1, IL-6 and IL-10 were analysed by colorimetric methods.

At admission 36.5, 30.3 and 30.6% of patients were deficient in erythrocyte Zn, Cu and Mg, respectively, increasing to 49, 46 and 41.2% at seventh day of ICU stay. There was significant differences between initial and final levels in plasma and erythrocyte (P<0.05, in three elements). A significant correlation was found between Zn administered by nutritional (PE and/or E) treatment (94% below RDIs) and erythrocyte Zn content (P<0.05) at seventh day, and erythrocyte Zn level is positively associated with erythrocyte Mg level content, TNF-β, IL-6 (P<0.02) and SOD activity (P<0.05) of critically ill patients.

Monitoring of Zn status is needed in critical care patients. Adequate intake of Zn, and Zn levels in plasma and erythrocyte is needed to be controlled at admission and during ICU stay of patients and may have prognostic, and perhaps therapeutic, implications. Development of Zn deficiency during an ICU stay may be associated with different metabolic, immune and clinical alterations that are attributed to other causes or are unknown, but complicate evolution of critically ill patient.

I declare that I do not have any affiliation with or financial interest in a commercial organisation that poses a conflict of interest.