Micronutrients: do small things matter?

Abstract

Despite the major developments on the importance of micronutrient status in health and disease, understanding of the exact role of the latter in critical illness remains elusive and ill defined, complicating decision-making on the part of the nutrition support practitioner. Micronutrient deficiencies in critically ill patients may occur as pre-existing conditions in patients with poor nutritional status prior to hospitalisation or as a result of severe illness or the injury itself. In practical terms it is clear that micronutrients should be provided at, at least, the current available recommended doses to prevent overt clinical deficiencies. For other claims/indications and higher doses the literature consistently indicate that the risk (adverse effects) to benefit (mortality) ratio may be favourable, and if such higher doses are used in practice it should be within the dose range that the current experience covers and for the clinical settings studied only.