ISSN (print) 1726-9806     ISSN (online) 1818-474X
No. 4 (2019), DIAGNOSTIC APPROACHES IN CRITICALLY ILL PATIENTS
No. 4 (2019)
DIAGNOSTIC APPROACHES IN CRITICALLY ILL PATIENTS

Screening of key protein and micronutrient metabolism markers in ICU patients with acute abdominal pathology. Article

Published 05.11.2019
A.V. Nikolenko
Perm State Medical University named by Е.А. Vagner Ministry of Health of the Russian Federation, Perm, Russia
https://orcid.org/0000-0002-1100-1901
Ilya N. Leiderman
National Medical Research Center named by V.A. Almazov Ministry of Health of the Russian Federation, St. Petersburg, Russia
https://orcid.org/0000-0001-8519-7145
V.V. Nikolenko
Perm State Medical University named by Е.А. Vagner Ministry of Health of the Russian Federation, Perm, Russia
https://orcid.org/0000-0002-9505-1569
#2019-4
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Keywords

malnutrition
acute abdominal surgical pathology
protein deficiency
trace elements

How to Cite

1.
Nikolenko A.V., Leiderman I.N., Nikolenko V.V. Screening of key protein and micronutrient metabolism markers in ICU patients with acute abdominal pathology. Article. Annals of Critical Care. 2019;(4):81-87. doi:10.21320/1818-474X-2019-4-81-87
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Abstract

Objectives. The purpose of this study is a comparative assessment of the dynamics of key markers of protein and micronutrient metabolism disorders in ICU patients with acute abdominal disease in survivors and non-survivors.

Materials and methods. A continuous screening was carried out for 532 patients hospitalized in surgical ICU. After analyzing 532 registration cards, two comparable groups were formed. Group 1 — survived patients. Group 2 — patients with negative clinical outcome.

Results. Serum albumin and transferrin in both groups were reduced already upon admission. By 7–10 days in non-survivors more significant decrease in total protein, albumin and transferrin was recorded. In survivors, a drop in these markers was also noted, however, their values were significantly higher. From admission both groups showed a decrease in the levels of iron, zinc and copper below normal, however, the survivors had significantly higher (p = 0.001) iron and copper serum concentrations. By 7–10 days in non-survivors, an even more significant decrease in these markers was noted compared with Day 1. Serum albumin levels were moderately correlated on Days 1 and 3 with the concentration of zinc (r = 0.448, p = 0.017 and r = 0.535, p = 0.003) and iron (r = 0.448, p = 0.008 and r = 0.535, p = 0.021), respectively. A strong link between transferrin and serum iron concentration was detected at Day 1 (r = 0.729, p = 0.000) and Day 10 (r = 0.821, p = 0.000), as well as with serum zinc levels (r = 0.713, p = 0.008 and r = 0.735, p = 0.012, respectively).

Conclusion. The relationship between visceral protein pool disorders and iron and zinc metabolism is most clearly detected.

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References

  1. Mercadal-Orfila G., Lluch-Taltavull J., Campillo-Artero C., Torrent-Quetglas M. Association between nutritional risk based on the NRS-2002 test and hospital morbidity and mortality. Nutr. Hosp. 2012; 27: 1248–1254. DOI: 10.3305/nh.2012.27.4.5791
  2. Edington J., Boorman J., Durrant E.R., et al. Prevalence of malnutrition on admission to four hospitals in England. Clin. Nutr. 2000; 19:.191–195.
  3. Waitzberg D.L., Caiaffa W.T., Correia M.I.T.D. Hospital malnutrition: The Brazilian National Survey (IBRANUTRI): A study of 4000 patients. Nutrition. 2001; 17: 573–580.
  4. Norman K., Pichard C., Lochs H., Pirlich M. Prognostic impact of disease-related malnutrition. Clin. Nutr. 2008; 27: 5–15.
  5. Sorensen J., Kondrup J., Prokopowicz J., et al. EuroOOPS: An international, multicentre study to implement nutritional risk screening and evaluate clinical outcome. Clin. Nutr. 2008; 27; 340–349.
  6. Николенко А.В., Шабунина Д.И., Николенко В.В. Метаболические изменения у пациентов с острой хирургической патологией органов брюшной полости. Сборник статей международной научно-практической конференции. В 4 частях. Инновации, технологии, наука. 2017: 218–221. [Nikolenko A.V., Shabunina D.I., Nikolenko V.V. Metabolicheskie izmeneniya u pacientov s ostroj hirurgicheskoj patologiej organov bryushnoj polosti. Sbornik statej mezhdunarodnoj nauchno-prakticheskoj konferencii. V 4 chastyah. Innovacii, tekhnologii, nauka. 2017: 218–221. (In Russ)]
  7. Stratton R.J., Hackston A., Longmore D., et al. Malnutrition in hospital outpatients and inpatients: Prevalence, concurrent validity and ease of use of the “malnutrition universal screening tool” (“MUST”) for adults. Br. J. Nutr. 2004; 92: 799–808.
  8. Луфт В.М., Афончиков В.С., Дмитриев А.В. и др. Руководство по клиническому питанию [руководство]. СПб.: Арт-Экспресс, 2016.[Luft V.M., Afonchikov V.S., Dmitriev A.V., et al. Rukovodstvo po klinicheskomu pitaniyu [rukovodstvo]. St. Petersburg: Art-Ekspress, 2016. (In Russ)]
  9. Бояринцев В.В., Евсеев М.А. Метаболизм и нутритивная поддержка хирургического пациента. СПб.: Онли-Пресс, 2017. [Boyarincev V.V., Evseev M.A. Metabolizm i nutritivnaya podderzhka hirurgicheskogo pacienta. St. Petersburg: Onli-Press, 2017. (In Russ)]
  10. Rech M., To L., Tovbin A., et al. Heavy metal in the intensive care unit: a review of current literature on trace element supplementation in critically ill patients. Nutr Clin Pract. 2014; 29: 78–89. DOI 10.1177/0884533613515724
  11. Cander B., Dundar Z.D., Gul M., Girisgin S. Prognostic value of serum zinc levels in critically ill patients. J Crit Care. 2011; 26: 42–46. DOI: 10.1016/j.jcrc.2010.06.002
  12. Heyland D.K., Jones N., Cvijanovich N.Z., Wong H. Zinc supplementation in critically ill patients: a key pharmaconutrient? JPEN J Parenter Enteral Nutr. 2008; 32: 509–519. DOI: 10.1177/0148607108322402
  13. Besecker B.Y., Exline M.C., 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. DOI: org/10.3945/ajcn.110.008417
  14. McClave S.A., Taylor B.E., Martindale R.G., et al. Guidelines for the provision and assessment of nutrition support therapy in the adult critically ill patient: Society of Critical Care Medicine (SCCM) and American Society for Parenteral and Enteral Nutrition (ASPEN) JPEN. J Parenter Enteral Nutr. 2016; 40: 159–211. DOI: 10.1177/0148607115621863
  15. Stefanowicz F., Gashut R.A., Talwar D., et al. Assessment of plasma and red cell trace element concentrations, disease severity, and outcome in patients with critical illness. J Crit Care. 2014; 29: 214–218. DOI: 10.1016/j.jcrc.2013.10.012
  16. Singer P., Berger M.M., Van den Berghe G., et al. ESPEN Guidelines on Parenteral Nutrition: intensive care. Clin Nutr. 2009; 28: 387–400. DOI: 10.1016/j.clnu.2009.04.024
  17. Marx G. Fluid therapy in sepsis with capillary leakage. European Journal of Anaesthesiology. 2003; 20(6): 429–442.
  18. Поляков И.В., Лейдерман И.Н., Золотухин К.Н. Проблема белково-энергетической недостаточности в отделениях реанимации интенсивной терапии хирургического профиля. Вестник интенсивной терапии. 2017; 1; 56–66. [Polyakov I.V., Lejderman I.N., Zolotuhin K.N. Problema belkovo-energeticheskoj nedostatochnosti v otdeleniyah reanimacii intensivnoj terapii hirurgicheskogo profilya. Vestnik intensivnoj terapii. 2017; 1: 56–66. (In Russ)]
  19. Jain S., Gautam V., Naseem S. Acute-phase proteins: As diagnostic tool. J. Pharm. Bioallied Sci. 2011: 1; 118–127.
  20. Kalantar-Zadeh K., Kleiner M., Dunne E., et al. Total iron-binding capacity-estimated transferrin correlates with the nutritional subjective global assessment in haemodialysis patients. Am. J. Kidney Dis. 1998, 31, 263–272.
  21. Lee Y.H., Bang E.-S., Lee J.-H., et al. Serum Concentrations of Trace Elements Zinc, Copper, Selenium, and Manganese in Critically Ill Patients. Biological Trace Element Research. 2019; 188: 316–325. DOI: 10.1007/s12011-018-1429-4
  22. Свиридов С.В., Федоров С.В., Алиева Т.У., Розумейко В.П. Биомаркеры системного воспаления и уровень микроэлементов Zn++ и Cu++ при оценке тяжести состояния хирургических больных с гнойными ранами мягких тканей. Российский медицинский журнал. 2010; 5: 19–21. [Sviridov S.V., Fedorov S.V., Alieva T.U., Rozumejko V.P. Biomarkery sistemnogo vospaleniya i uroven’ mikroelementov Zn++ i Cu++ pri ocenke tyazhesti sostoyaniya hirurgicheskih bol’nyh s gnojnymi ranami myagkih tkanej. Rossijskij medicinskij zhurnal. 2010; 5: 19–21. (In Russ)]
  23. Свиридов С.В., Федоров С.В., Алиева Т.У. и др. О чем «молчат» микроэлементы. Вестник интенсивной терапии. 2012; 2: 11–17.[Sviridov S.V.,Fedorov S.V. Alieva T.U., et al. O chem “molchat” mikroelementy. Vestnik intensivnoj terapii. 2012; 2: 11–17. (In Russ)]
  24. Berger M.M., Baines M., Raffoul W., et al. Trace element supplementation after major burns modulates antioxidant status and clinical course by way of increased tissue trace element concentrations. Am J Clin Nutr. 2007; 85(5): 1293–1300.
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