Monitoring and parenteral administration of micronutrients, phosphate and magnesium in critically ill patients: The VITA-TRACE survey.

Vankrunkelsven, Wouter; Gunst, Jan; Amrein, Karin; Bear, Danielle E; Berger, Mette M; Christopher, Kenneth B; Fuhrmann, Valentin; Hiesmayr, Michael; Ichai, Carole; Jakob, Stephan M; Lasocki, Sigismond; Montejo, Juan C; Oudemans-van Straeten, Heleen M; Preiser, Jean-Charles; Blaser, Annika Reintam; Rousseau, Anne-Françoise; Singer, Pierre; Starkopf, Joel; van Zanten, Arthur R; Weber-Carstens, Steffen; ... (2021). Monitoring and parenteral administration of micronutrients, phosphate and magnesium in critically ill patients: The VITA-TRACE survey. Clinical nutrition, 40(2), pp. 590-599. Elsevier 10.1016/j.clnu.2020.06.005

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BACKGROUND & AIMS

Despite the presumed importance of preventing and treating micronutrient and mineral deficiencies, it is still not clear how to optimize measurement and administration in critically ill patients. In order to design future comparative trials aimed at optimizing micronutrient and mineral management, an important first step is to gain insight in the current practice of micronutrient, phosphate and magnesium monitoring and administration.

METHODS

Within the metabolism-endocrinology-nutrition (MEN) section of the European Society of Intensive Care Medicine (ESICM), the micronutrient working group designed a survey addressing current practice in parenteral micronutrient and mineral administration and monitoring. Invitations were sent by the ESICM research department to all ESICM members and past members.

RESULTS

Three hundred thirty-four respondents completed the survey, predominantly consisting of physicians (321 [96.1%]) and participants working in Europe (262 [78.4%]). Eighty-one (24.3%) respondents reported to monitor micronutrient deficiencies through clinical signs and/or laboratory abnormalities, and 148 (44.3%) reportedly measure blood micronutrient concentrations on a routine basis. Two hundred ninety-two (87.4%) participants provided specific data on parenteral micronutrient supplementation, of whom 150 (51.4%) reported early administration of combined multivitamin and trace element preparations at least in selected patients. Among specific parenteral micronutrient preparations, thiamine (146 [50.0%]) was reported to be the most frequently administered micronutrient, followed by vitamin B complex (104 [35.6%]) and folic acid (86 [29.5%]). One hundred twenty (35.9%) and 113 (33.8%) participants reported to perform daily measurements of phosphate and magnesium, respectively, whereas 173 (59.2%) and 185 (63.4%) reported to routinely supplement these minerals parenterally.

CONCLUSION

The survey revealed a wide variation in current practices of micronutrient, phosphate and magnesium measurement and parenteral administration, suggesting a risk of insufficient prevention, diagnosis and treatment of deficiencies. These results provide the context for future comparative studies, and identify areas for knowledge translation and recommendations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic of Intensive Care

UniBE Contributor:

Jakob, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0261-5614

Publisher:

Elsevier

Language:

English

Submitter:

Jsabelle Arni

Date Deposited:

17 Dec 2020 12:05

Last Modified:

23 Feb 2021 18:59

Publisher DOI:

10.1016/j.clnu.2020.06.005

PubMed ID:

32624243

Uncontrolled Keywords:

Critical illness Magnesium Micronutrients Nutrition Phosphate Refeeding syndrome

BORIS DOI:

10.7892/boris.149733

URI:

https://boris.unibe.ch/id/eprint/149733

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