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

Vankrunkelsven, W.; Gunst, J.; Amrein, K.; Bear, D. E.; Berger, Mette; Christopher, K. B.; Fuhrmann, V.; Hiesmayr, M.; Ichai, C.; Jakob, S. M.; Lasocki, S.; Montejo, J. C.; Oudemans-van Straeten, H. M.; Preiser, J.-C.; Blaser, A. R.; Rousseau, Anne-Françoise; Singer, P.; Starkopf, J.; van Zanten, A. R.; Weber-Carstens, S.; Wernerman, J.; Wilmer, A.; Casaer, M. P.

doi:10.1016/j.clnu.2020.06.005

Article (Scientific journals)

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

Vankrunkelsven, W.; Gunst, J.; Amrein, K. et al.

2020 • In Clinical Nutrition

Peer Reviewed verified by ORBi

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https://hdl.handle.net/2268/262351

DOI
10.1016/j.clnu.2020.06.005

PubMed
32624243

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Keywords :

Critical illness; Magnesium; Micronutrients; Nutrition; Phosphate; Refeeding syndrome

Abstract :

[en] 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. © 2020 The Authors

Disciplines :

Anesthesia & intensive care

Author, co-author :

Vankrunkelsven, W.; KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium

Gunst, J.; KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium

Amrein, K.; Medical University of Graz, Division of Endocrinology and Diabetology, Department of Internal Medicine, Graz, Austria

Bear, D. E.; Guy´s and St Thomas’ NHS Foundation Trust, Department of Critical Care and Department of Nutrition and Dietetics, London, United Kingdom

Berger, Mette

Christopher, K. B.; Brigham and Women´s Hospital, Division of Renal Medicine, Boston, United States

Fuhrmann, V.; University Medical Center Hamburg-Eppendorf, Department for Intensive Care Medicine, Hamburg, Germany

Hiesmayr, M.; Klinische Abteilung für Herz-Thorax-Gefäßchirurgische Anästhesie & Intensivmedizin, Medizinische Universität WienVienna, Austria

Ichai, C.; University Côte d´Azur, CHU de Nice, Hôpital Pasteur 2, Department of Anesthesiology and Critical Care Medicine, Nice, France

Jakob, S. M.; Inselspital, Bern University Hospital, University of Bern, Department of Intensive Care Medicine, Bern, Switzerland

More authors (13 more)

Language :

English

Title :

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

Publication date :

2020

Journal title :

Clinical Nutrition

ISSN :

0261-5614

eISSN :

1532-1983

Publisher :

Churchill Livingstone

Peer reviewed :

Peer Reviewed verified by ORBi

Funders :

KU Leuven: C24/17/070Fonds Wetenschappelijk Onderzoek, FWO: 1832817NFonds Wetenschappelijk Onderzoek, FWO: 1832817NPfizer

Available on ORBi :

since 31 July 2021

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