내과계 중환자에서 미량원소 공급 평가: 셀레늄과 아연
Assessment of Trace Element Supplementation in Critically Ill Medical Patients: Selenium and Zinc
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Background : The ESPEN (the European Society for Clinical Nutrition and Metabolism) guideline recommends that critically ill patients be provided daily supplementation of trace elements. Among such trace elements, selenium and zinc have been used in studies examining the correlation between serum concentration and treatment outcomes in critically ill surgical patients. However, there have been limited works evaluating the supplementation of selenium and zinc on critically ill medical patients. The aim of the present study was to evaluate the serum concentration and supplementation status of selenium and zinc in critically ill medical patients. Methods : The research was conducted by retrospectively reviewing the electronic medical records of patients aged 18 years or older who were admitted to the medical intensive care unit (MICU) of Samsung Medical Center from January 2022 to May 2023. Results : In total, among the 94 patients (selenium 41, zinc 53) whose serum concentration was confirmed at the time of admission to the MICU, 32 patients (78.0%) were below the normal selenium level whereas 34 patients (64.2%) were below the normal zinc level. Of these respective groups of patients, 19 (59.4%) were supplied selenium, while 15 (44.1%) were supplied zinc during the period. The average serum concentration before and after supplementation were selenium 53.79±12.92 μg/L and 64.14±26.08 μg/L, respectively, and zinc 49.33±11.92 μg/dL and 51.25±20.65 μg/dL, respectively. Among the patients whose selenium concentration was below the normal level at the time of admission to the MICU, the septic shock patient group had a significantly lower selenium serum concentration (47.00±16.09 μg/L vs. 63.38±17.34 μg/L, p=0.031). Conclusion : Fundamental data for the evaluation of the serum concentration and supplementation of selenium and zinc in critically ill medical patients were prepared. As there were not many cases of patients for whom serum concentration and supplementation of trace elements were monitored after the initial admission in the MICU, there is a need for more active intervention. To determine the effects of serum selenium and zinc levels on critically ill medical patients, there is also a need for a large-scale prospective study as further research.
Abstract
Background : The ESPEN (the European Society for Clinical Nutrition and Metabolism) guideline recommends that critically ill patients be provided daily supplementation of trace elements. Among such trace elements, selenium and zinc have been used in studies examining the correlation between serum concentration and treatment outcomes in critically ill surgical patients. However, there have been limited works evaluating the supplementation of selenium and zinc on critically ill medical patients. The aim of the present study was to evaluate the serum concentration and supplementation status of selenium and zinc in critically ill medical patients. Methods : The research was conducted by retrospectively reviewing the electronic medical records of patients aged 18 years or older who were admitted to the medical intensive care unit (MICU) of Samsung Medical Center from January 2022 to May 2023. Results : In total, among the 94 patients (selenium 41, zinc 53) whose serum concentration was confirmed at the time of admission to the MICU, 32 patients (78.0%) were below the normal selenium level whereas 34 patients (64.2%) were below the normal zinc level. Of these respective groups of patients, 19 (59.4%) were supplied selenium, while 15 (44.1%) were supplied zinc during the period. The average serum concentration before and after supplementation were selenium 53.79±12.92 μg/L and 64.14±26.08 μg/L, respectively, and zinc 49.33±11.92 μg/dL and 51.25±20.65 μg/dL, respectively. Among the patients whose selenium concentration was below the normal level at the time of admission to the MICU, the septic shock patient group had a significantly lower selenium serum concentration (47.00±16.09 μg/L vs. 63.38±17.34 μg/L, p=0.031). Conclusion : Fundamental data for the evaluation of the serum concentration and supplementation of selenium and zinc in critically ill medical patients were prepared. As there were not many cases of patients for whom serum concentration and supplementation of trace elements were monitored after the initial admission in the MICU, there is a need for more active intervention. To determine the effects of serum selenium and zinc levels on critically ill medical patients, there is also a need for a large-scale prospective study as further research.
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