PMID- 18407905
OWN - NLM
STAT- MEDLINE
DCOM- 20080630
LR  - 20131121
IS  - 0148-6071 (Print)
IS  - 0148-6071 (Linking)
VI  - 32
IP  - 2
DP  - 2008 Mar-Apr
TI  - Trace element loss in urine and effluent following traumatic injury.
PG  - 129-39
LID - 10.1177/0148607108314762 [doi]
AB  - BACKGROUND: Few data are available to establish recommendations for trace element 
      supplementation during critical illness. This study quantified the loss of 
      several elements and assessed the adequacy of manganese and selenium in 
      parenteral nutrition (PN). METHODS: Men with traumatic injuries were grouped by 
      renal status: adequate (POLY; n = 6), acute failure with continuous venovenous 
      hemofiltration (CVVH; n = 2), or continuous venovenous hemodiafiltration (CVVHD; 
      n = 4). PN supplied 300 microg/d manganese and 60 microg/d selenium. Urine and 
      effluent (from artificial kidneys) were collected for 3 days and analyzed for 
      boron, manganese, nickel, and silicon using inductively coupled plasma atomic 
      emission spectrometry, and for selenium using atomic absorption spectrometry. 
      RESULTS: POLY manganese and selenium excretion averaged (standard deviation [SD]) 
      7.9 (3.3) microg/d and 103.5 (22.4) microg/d, respectively. All elements except 
      selenium were detected in dialysate (prior to use). CVVHD effluent contained 3.5 
      and 7.3 times more manganese and nickel than CVVH ultrafiltrate, respectively. 
      Loss of manganese averaged 2.6%, 21%, and 73% of PN amounts for POLY, CVVH, and 
      CVVHD groups, respectively. DISCUSSION: Minimal loss of manganese compared with 
      the amount in PN suggests that excessive amounts are retained. POLY patients 
      excreted more selenium than was in PN, indicating negative balance. POLY losses 
      of boron and silicon were less than that published for healthy adults, reflecting 
      less than typical intake, whereas loss during CVVH was in the normal reference 
      range, possibly because of added intake from boron contamination of replacement 
      fluids. All patients lost more nickel than amounts published for healthy adults. 
      CONCLUSIONS: Current guidelines of 60-100 microg/d of parenteral manganese may be 
      excessive for trauma patients. The uptake of manganese and nickel from 
      contaminants in CVVHD dialysate should be investigated.
FAU - Klein, Catherine J
AU  - Klein CJ
AD  - Bionutrition Research Program, General Clinical Research Center, Children's 
      National Medical Center, Washington, DC 20010, USA. CKlein@cnmc.org
FAU - Nielsen, Forrest H
AU  - Nielsen FH
FAU - Moser-Veillon, Phylis B
AU  - Moser-Veillon PB
LA  - eng
PT  - Journal Article
PL  - United States
TA  - JPEN J Parenter Enteral Nutr
JT  - JPEN. Journal of parenteral and enteral nutrition
JID - 7804134
RN  - 0 (Trace Elements)
RN  - 42Z2K6ZL8P (Manganese)
RN  - 7OV03QG267 (Nickel)
RN  - H6241UJ22B (Selenium)
RN  - N9E3X5056Q (Boron)
RN  - Z4152N8IUI (Silicon)
SB  - IM
MH  - Acute Kidney Injury/*metabolism/therapy
MH  - Adolescent
MH  - Adult
MH  - Boron/analysis/urine
MH  - Critical Illness/*therapy
MH  - Female
MH  - Food Contamination/analysis
MH  - Humans
MH  - Male
MH  - Manganese/administration & dosage/analysis/urine
MH  - Middle Aged
MH  - Nickel/administration & dosage/analysis/urine
MH  - Nutritional Requirements
MH  - *Parenteral Nutrition/adverse effects
MH  - *Renal Replacement Therapy
MH  - Selenium/administration & dosage/analysis/urine
MH  - Silicon/administration & dosage/analysis/urine
MH  - Trace Elements/administration & dosage/*analysis/urine
EDAT- 2008/04/15 09:00
MHDA- 2008/07/01 09:00
CRDT- 2008/04/15 09:00
PHST- 2008/04/15 09:00 [pubmed]
PHST- 2008/07/01 09:00 [medline]
PHST- 2008/04/15 09:00 [entrez]
AID - 32/2/129 [pii]
AID - 10.1177/0148607108314762 [doi]
PST - ppublish
SO  - JPEN J Parenter Enteral Nutr. 2008 Mar-Apr;32(2):129-39. doi: 
      10.1177/0148607108314762.