Antioxidants and micronutrient supplementation in trauma patients

Current Opinion in Clinical Nutrition and Metabolic Care

Volumn 15, Issue 2, 2012, Pages 181-187

  Reddell, Leslie ^a   Cotton, Bryan A ^a,b  

^a UNIVERSITY OF TEXAS MEDICAL SCHOOL   (United States)

^b UNIVERSITY OF TEXAS   (United States)

Author keywords

antioxidants; arginine; critically ill; fatty acids; glutamine; intensive care unit; N acetyl cystine; oxidative stress; pharmaconutrition; selenium; vitamin C; zinc

Indexed keywords

ACETYLCYSTEINE; ALPHA TOCOPHEROL; ANTIOXIDANT; ARGININE; ASCORBIC ACID; FATTY ACID; FISH OIL; GLUTAMINE; OMEGA 3 FATTY ACID; SELENIUM; TRACE ELEMENT; ZINC;

ANTIOXIDANT ACTIVITY; DIET SUPPLEMENTATION; DIET THERAPY; HUMAN; INJURY; INTENSIVE CARE; INTENSIVE CARE UNIT; OXIDATIVE STRESS; RECOMMENDED DRUG DOSE; REVIEW;

ANTIOXIDANTS; ARGININE; ASCORBIC ACID; CRITICAL ILLNESS; CYSTINE; DIETARY SUPPLEMENTS; FATTY ACIDS; GLUTAMINE; HUMANS; INTENSIVE CARE UNITS; MICRONUTRIENTS; OXIDATIVE STRESS; SELENIUM; ZINC;

EID: 84857061071     PISSN: 13631950     EISSN: 14736519     Source Type: Journal    
DOI: 10.1097/MCO.0b013e32835076df     Document Type: Review

References (40)

1. Rinaldi S, Landucci F, De Gaudio AR. Antioxidant therapy in critically septic patients. Curr Drug Targets 2009; 10:872-880.
2. Galley HF. Oxidative stress and mitochondrial dysfunction in sepsis. Br J Anaesth 2011; 107:57-64.
3. Heyland D, Dhaliwal R. Immunonutrition in the critically ill: From old approaches to new paradigms. Intensive Care Med 2005; 31:501-503. (Pubitemid 40543877)
4. Jones NE, Heyland DK. Pharmaconutrition: A new emerging paradigm. Curr Opin Gastroenterol 2008; 24:215-222. (Pubitemid 351322790)
5. Santora R, Kozar RA. Molecular mechanisms of pharmaconutrients. J Surg Res 2009; 161:288-294.
6. Todd SR, Gonzalez EA, Turner K, et al. Update on postinjury nutrition. Curr Opin Crit Care 2008; 14:690-695.
7. Luo M, Fernandez-Estivariz C, Jones DP, et al. Depletion of plasma antioxidants in surgical intensive care unit patients requiring parenteral feeding: Effects of parenteral nutrition with or without alanyl-glutamine dipeptide supplementation. Nutrition 2008; 24:37-44. (Pubitemid 50008237)
8. Heyland DK, Dhaliwal R, Suchner U, et al. Antioxidant nutrients: A systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Med 2005; 31:327-337.
9. Dupertuis YM, Meguid MM, Pichard C. Advancing from immunonutrition to a pharmaconutrition: A gigantic challenge. Curr Opin Clin Nutr Metab Care 2009; 12:398-403.
10. Mizock BA. Immunonutrition and critical illness: An update. Nutrition 2010; 26:701-707.
11. Weitzel LR, Mayles WJ, Sandoval PA, et al. Effects of pharmaconutrients on cellular dysfunction and the microcirculation in critical illness. Curr Opin Anaesthesiol 2009; 22:177-183.
12. Luo M, Bazargan N, Griffith DP, et al. Metabolic effects of enteral versus parenteral alanyl-glutamine dipeptide administration in critically ill patients receiving enteral feeding: A pilot study. Clin Nutr 2008; 27:297-306.
13. Taylor B, Krenitsky J. Nutrition in the intensive care unit: Year in review 2008-2009. J Parenter Enteral Nutr 2010; 34:21-31.
14. Weitzel LR, Wischmeyer PE. Glutamine in critical illness: The time has come, the time is now. Crit Care Clin 2010; 26:515-525; ix-x.
15. Alves WF, Aguiar EE, Guimaraes SB, et al. L-Alanyl-glutamine preoperative infusion in patients with critical limb ischemia subjected to distal revascularization reduces tissue damage and protects from oxidative stress. Ann Vasc Surg 2010; 24:461-467. An interesting study reporting preoperative administration of L-Alanyl-glutamine reduces muscle damage and enhanced antioxidant levels in patients with critical limb ischemia.
16. Gough MS, Morgan MA, Mack CM, et al. The ratio of arginine to dimethylarginines is reduced and predicts outcomes in patients with severe sepsis. Crit Care Med 2011; 39:1351-1358.
17. Forceville X, Laviolle B, Annane D, et al. Effects of high doses of selenium, as sodium selenite, in septic shock: A placebo-controlled, randomized, doubleblind, phase II study. Crit Care 2007; 11:R73.
18. Manzanares W, Biestro A, Galusso F, et al. High-dose selenium for critically ill patients with systemic inflammation: Pharmacokinetics and pharmacodynamics of selenious acid: A pilot study. Nutrition 2010; 26:634-640.
19. Manzanares W, Hardy G. Selenium supplementation in the critically ill: Posology and pharmacokinetics. Curr Opin Clin Nutr Metab Care 2009; 12:273-280.
20. Manzanares W, Biestro A, Torre MH, et al. High-dose selenium reduces ventilator-Associated pneumonia and illness severity in critically ill patients with systemic inflammation. Intensive Care Med 2011; 37:1120-1127. A prospective, placebo-controlled, randomized trial of high-dose selenium supplementation. The authors demonstrated that supplementation decreased mean SOFA scores and pneumonia rates. The treatment achieved these outcomes without adverse events.
21. Valenta J, Brodska H, Drabek T, et al. High-dose selenium substitution in sepsis: A prospective randomized clinical trial. Intensive Care Med 2011; 37:808-815. A prospective, randomized trial involving 150 critically ill patients with SIRS/sepsis and a SOFA score greater than 5. Patients were randomized patients to receive placebo or a high-dose selenium supplementation for a total course of 14 days. No difference was appreciated in mortality or markers of inflammation between the groups and selenium supplementation had no significant effects on major study endpoints.
22. Angstwurm MW, Engelmann L, Zimmermann T, et al. Selenium in Intensive Care (SIC): Results of a prospective randomized, placebo-controlled, multiplecenter study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. Crit Care Med 2007; 35:118-126. (Pubitemid 46035686)
23. Cander B, Dundar ZD, Gul M, et al. Prognostic value of serum zinc levels in critically ill patients. J Crit Care 2010; 26:42-46. An observational study demonstrating that serum zinc levels are inversely proportional to SOFA scores and organ failure. Demonstrates that critical illness leads to a decline in serum zinc concentrations.
24. Besecker BY, Exline MC, Hollyfield J, et al. A comparison of zinc metabolism, inflammation, and disease severity in critically ill infected and noninfected adults early after intensive care unit admission. Am J Clin Nutr 2011; 93:1356-1364.
25. Heyland DK, Jones N, Cvijanovich NZ, et al. Zinc supplementation in critically ill patients: A key pharmaconutrient? J Parenter Enteral Nutr 2008; 32:509-519.
26. Lehr HA, Germann G, McGregor GP, et al. Consensus meeting on 'Relevance of parenteral vitamin C in acute endothelial dependent pathophysiological conditions (EDPC)'. Eur J Med Res 2006; 11:516-526. (Pubitemid 46040282)
27. Kahn SA, Beers RJ, Lentz CW. Resuscitation after severe burn injury using high-dose ascorbic acid: A retrospective review. J Burn Care Res 2010; 32:110-117.
28. Tanaka H, Matsuda T, Miyagantani Y, et al. Reduction of resuscitation fluid volumes in severely burned patients using ascorbic acid administration: A randomized, prospective study. Arch Surg 2000; 135:326-331. (Pubitemid 30154575)
29. Bosma KJ, Taneja R, Lewis JF. Pharmacotherapy for prevention and treatment of acute respiratory distress syndrome: Current and experimental approaches. Drugs 2010; 70:1255-1282.
30. Yang R, Harris WS, Vernon K, et al. Prefeeding with omega-3 fatty acids suppresses inflammation following hemorrhagic shock. J Parenter Enteral Nutr 2010; 34:496-502.
31. Pontes-Arruda A, Martins LF, de Lima SM, et al. Enteral nutrition with eicosapentaenoic acid, gamma-linolenic acid and antioxidants in the early treatment of sepsis: Results from a multicenter, prospective, randomized, double-blinded, controlled study: The INTERSEPT Study. Crit Care 2011; 15:R144. A prospective, randomized study (INTERSEPT Study Group) evaluating patients fed a diet of eicosapentaenoic acid, g-linolenic acid, and antioxidants versus a control enteral diet. The study demonstrated that treatment patients developed less severe sepsis and/or septic shock over control group, as well as less cardiovascular and respiratory. Whereas this translated into reduced hospital and ICU length of stay, and overall cost of patient care, there was no effect on 28-day mortality.
32. Coeffier M, Dechelotte P. Combined infusion of glutamine and arginine: Does it make sense? Curr Opin Clin Nutr Metab Care 2010; 13:70-74.
33. Nathens AB, Neff MJ, Jurkovich GJ, et al. Randomized, prospective trial of antioxidant supplementation in critically ill surgical patients. Ann Surg 2002; 236:814-822. (Pubitemid 35403237)
34. Collier BR, Giladi A, Dossett LA, et al. Impact of high-dose antioxidants on outcomes in acutely injured patients. J Parenter Enteral Nutr 2008; 32:384-388. (Pubitemid 351875946)
35. Giladi AM, Dossett LA, Fleming SB, et al. High-dose antioxidant administration is associated with a reduction in postinjury complications in critically ill trauma patients. Injury 2010; 42:78-82. A large retrospective cohort study (>4000 patients) demonstrating the impact of a high-dose antioxidant protocol of vitamin C, vitamin E, and selenium supplementation. Authors noted a reduction in infectious and abdominal wall complications.
36. Berger MM, Soguel L, Shenkin A, et al. Influence of early antioxidant supplements on clinical evolution and organ function in critically ill cardiac surgery, major trauma, and subarachnoid hemorrhage patients. Crit Care 2008; 12:R101.
37. Visser J, Labadarios D, Blaauw R. Micronutrient supplementation for critically ill adults: A systematic review and meta-Analysis. Nutrition 2011; 27:745-758. A meta-Analysis of 18 randomized controlled trials examining endpoints of mortality, infections complications, and ICU and hospital LOS. This meta-Analysis found only borderline significant difference with single nutrient supplementation in regards to mortality with a significant difference in mortality in the combination micronutrient groups.
38. Rice TW, Wheeler AP, Thompson BT, et al. Enteral omega-3 fatty acid, gamma-linolenic acid, and antioxidant supplementation in acute lung injury. J Am Med Assoc 2011; 306:1574-1581.
39. Schneider A, Markowski A, Momma M, et al. Tolerability and efficacy of a lowvolume enteral supplement containing key nutrients in the critically ill. Clin Nutr 2011; 30:599-603. A prospective, randomized trial of critically ill patients receiving either low-volume enteral supplementation containing key nutrients or diluted standard elemental nutrition. Whereas increased uptake of selenium and vitamin E was observed, there were no differences over the control group in regards to fever, antibiotic treatment, mechanical ventilation, length of stay and mortality.
40. Heyland DK, Dhaliwal R, Day AG, et al. REducing Deaths due to OXidative Stress (The REDOXS Study): Rationale and study design for a randomized trial of glutamine and antioxidant supplementation in critically-ill patients. Proc Nutr Soc 2006; 65:250-263. (Pubitemid 46323840)