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Should zinc and selenium supplements belong to standard care in the ICU?

Zinc deficiency increases organ damage and mortality in a murine model of polymicrobial sepsis.

Knoell DL, Julian MW, Bao S, et al.                                                                                                                    Crit Care Med 2009; 37:1380-8

Division of Pulmonary, Allergy, Critical Care, and Sleep Medicine, Dorothy M. Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, OH, USA.

In a well controlled model of peritonitis induced by cecal ligation and punc­ture, Knoell et al. (Knoell DL; Crit Care Med 2009; 37:1380) investigated the influence of zinc (Zn) status on response to sepsis. Mice were assigned to three groups: Control diet, Zn-deficient and Zn-deficient followed by oral Zn supplementation for 3 days. The results are impressing and the authors demonstrate mainly that:

  1. prior Zn deficiency significantly  increases organ dysfunction, inflammation and mortality from sepsis,

  2. a short Zn supplementation using pharmacological doses is able to reduce these alterations, normalizing the inflammatory response (as measured by a variety of markers) and reducing tissue damage mainly in the lung.

Another animal study (in press) confirms the beneficial effects of supplements in a rabbit model of major trauma and shows that zinc supplementation reduces the activation of NFκB and the inflammatory response, with less organ failures (Yuan XA; J Trace Elem Med Biol 2009 in press).

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