B. Micronutrient Support

Micronutrients are compounds found in small quantities in all tissues. They are essential for cellular function and, therefore, for survival. It is becoming increasingly clear that marked deficiencies in key micronutrients occur during the severe stress response as a result of:

1) Increased losses

2) Increased consumption during metabolism

3) Inadequate replacement

Because micronutrients are essential for cellular function, a deficiency state further amplifies severe injury-induced metabolic derangements and ongoing catabolism. The functions of micronutrients can be categorized as follows:

• Support of the hypermetabolic state

• Support of anabolism

• Support of immune function

• Support of wound healing

 

The micronutrients include key essential amino acids, such as glutamine and arginine; organic compounds (vitamins); and inorganic compounds (trace minerals). These compounds are both utilized and excreted at a more rapid rate after injury, leading to well documented deficiencies. However, because measurement of levels is difficult, if not impossible, prevention of a deficiency is accomplished only by providing increased intake. Deficiency states can lead to severe morbidity because adequate amounts of these key components are essential for minimizing complications.

 

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