tailieunhanh - Báo cáo y học: "Substitution of exudative trace element losses in burned children"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Substitution of exudative trace element losses in burned children. | Stucki et al. Critical Care 2010 14 439 http content 14 4 439 CRITICAL CARE LETTER L_ Substitution of exudative trace element losses in burned children Ct i irl 1 M 2 rid-1 I ol Porov Mfr ll IOC xti i n i1 A M n Qhon l in2 2 n d Motto K 1 Don ior3 rabid l Stucki Mdrie nclcncrcl ez JdcquesCoLLiny Aldl ISI lei IMI I dnUMcllcMDciyei We describe an intravenous copper-selenium-zinc substitution policy in children with major burns using adult doses adapted to total body surface area. Blood levels and clinical course confirm its safety with a rapidly favourable clinical evolution. Major burn injuries are associated with trace element deficiencies which lead to impaired wound healing and infectious complications. Low plasma levels of zinc Zn and copper Cu are inadequately compensated for during hospitalization 1 and enteral supplements are unsuccessful in correcting the status 2 . Additionally there are currently no clear recommendations regarding trace element requirements in children. The aim of the present study was to determine if our trace element supplementation policy for adults adapted to total body surface area would achieve normalization of plasma concentrations of trace elements in burned children. Burned children admitted to the paediatric and adult ICU were enrolled after approval by the Institutional Ethics Committee and parental informed consent. Parkland formula was used for fluid resuscitation during the first 24 hours in addition to basal fluid requirements 1 800 ml m 2 . Target nutrition from 36 to 48 hours was 3 to 5 year olds 70 to 90 kcal kg day over 5 year olds 50 to 70 kcal kg day teenagers 40 kcal kg day. A normal saline solution containing Cu selenium Se and Zn Table 1 3 was infused continuously first within 12 hours of injury and then over 8 hours per day for 7 to 15 days at a dose of 250 ml m2 day along with a standard parenteral multi-trace element preparation. In addition children admitted to the paediatric ICU received