ASSESSMENT OF VITAMIN AND TRACE-ELEMENT SUPPLEMENTATION IN SEVERELY BURNED PATIENTS UNDERGOING LONG-TERM PARENTERAL AND ENTERAL NUTRITION

The efficacy of an oral supplement of vitamins and trace elements duri ng a longterm artificial parenteral and enteral nutrition was investig ated for 3 months in patients with extensive burns. Thirty severely bu rned patients (22 male, 8 female, age 41 +/- 18 years, range 23-59 yea rs, 33 +/- 12% total body surface area burn, 22% +/- 8 full thickness burn surface area) were included. Every 10 days, from day 10 until day 90, we determined serum levels of: vitamins B1, B12, A, E folic acid copper, zinc, iron transferrin, albumin, prealbumin, total proteins fi bronectin, retinol binding protein (REP) calcium phosphorus triglyceri des total cholesterol C reactive protein (CRP) erythrocyte folic acid The mean daily nutritional support was 60 Kcals and 0.4 g N per kg of body weight, 70% enterally and 30% parenterally administered, with ent eral vitamin and trace element supplementation. On day 10, there was a decrease of the serum level of 19/20 parameters. For 8 parameters (vi tamin A, total cholesterol, iron, transferrin, fibronectin, phosphorus , RBP, total proteins), the level was lower than usual. Between day 10 and day 20, a significant normalization of 6 of them was noted, the a verage levels of transferrin and iron remaining below normal values un til day 50. There was a significant decrease in C reactive protein lev els, however above normal limits. No deficiency in vitamins or trace e lements was found. Cyclic variations of serum levels occurred which ma y be more related to volemic, hydroelectrolytic, endocrine and inflamm atory disorders than to nutritional problems.