COPPER, SELENIUM, AND ZINC STATUS AND BALANCES AFTER MAJOR TRAUMA

To investigate the trace elements (TE) losses and status after trauma, 11 severely injured patients (Injury Severity Score: 29 +/- 6), admit ted to the ICU were studied from the day of injury (D0) until D25. Bal ance studies were started within 24 hours after injury, until D7. Seru m and urine samples were collected from D1 to D7, then on D10, 15, 20, and 25, Intravenous TE supplementation was initiated upon admission. Serum: Selenium (Se) and zinc (Zn) levels were decreased until D7 and were normal thereafter. Losses: TE urinary excretions were higher than reference ranges until D20 in all patients. Fluid losses through drai ns contained large amounts of TE. Balances: Balances were slightly pos itive for copper (Cu) and Zn, and negative for Se from D5 to D7 despit e supplements. Cu status exhibited minor changes compared to those obs erved with the Zn and Se status: Serum levels were decreased and losse s increased. Considering the importance of Se and Zn in free radical s cavenging, anabolism, and immunity, current recommendations for TE sup plements in severely traumatized patients ought to be revised.