Micronutrient Deficiencies in Medical and Surgical Inpatients

被引:40
作者
Berger, Mette M. [1 ]
Pantet, Olivier [1 ]
Schneider, Antoine [1 ]
Ben-Hamouda, Nawfel [1 ]
机构
[1] Lausanne Univ Hosp CHUV, Serv Adult Intens Care Med & Burns, BH 08-612,Rue Bugnon 46, CH-1011 Lausanne, Switzerland
关键词
iron; copper; selenium; zinc; thiamine; vitamin B12; obesity; inflammation; enteral nutrition; CHRONIC-HEMODIALYSIS PATIENTS; CRITICALLY-ILL PATIENTS; VITAMIN-D DEFICIENCY; SELENIUM DEFICIENCY; SODIUM SELENITE; BARIATRIC SURGERY; ZINC-DEFICIENCY; CROHNS-DISEASE; LIVER-DISEASE; SEPTIC SHOCK;
D O I
10.3390/jcm8070931
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Inpatients are threatened by global malnutrition, but also by specific micronutrient (i.e., trace element and vitamins) deficiencies that frequently are overseen in the differential diagnosis of major organ dysfunctions. Some of them are related to specific geographic risks (iodine, iron, selenium, zinc, vitamin A), while others are pathology related, and finally many are associated with specific feeding patterns, including low dose enteral feeding. Among the pathologies in which laboratory blood investigations should include a micronutrient outwork, anemia is in the front line, followed by obesity with bariatric surgery, chronic liver disease, kidney disease, inflammatory bowel disease, cardiomyopathies and heart failure. The micronutrients at the highest risk are iron, zinc, thiamine, vitamin B12 and vitamin C. Admission to hospital has been linked with an additional risk of malnutrition-feeding below 1500 kcal/day was frequent and has been associated with a structural additional risk of insufficient micronutrient intake to cover basal needs. Although not evidence based, systematic administration of liberal thiamine doses upon admission, and daily complementation of inpatients' food and enteral feeding solutions with multi-micronutrient tablets might be considered.
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页数:17
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