Influence of early trace element and vitamin E supplements on antioxidant status after major trauma: a controlled trial

Negative selenium and zinc balances occur after major trauma, potentially c ompromising antioxidant defenses. The aim of this study was to determine if micronutrient supplementation could modulate the blood antioxidant status. 32 patients admitted to surgical ITU with major trauma were randomized to receive either selenium alone, selenium plus copper, zinc and tocopherol, o r placebo for 5 days after injury. Blood samples were collected on days 0, 1, 2, 5, 10 and 20 and analyzed for plasma selenium, copper, zinc, tocopher ol, glutathione peroxidase and total antioxidant capacity (TAC), and for er ythrocyte antioxidant enzymes. Plasma selenium and tocopherol concentration s were low on admission, but increased significantly (p = 0.001) with suppl ementation, whereas there was an early significant fall in TAC (p < 0.002) in the selenium supplemented groups. Plasma glutathione peroxidase activity increased significantly between days 2 and 5 with supplementation (p = 0.0 2), but erythrocyte enzyme activity was unaffected. The unexpected early fa ll in plasma TAC with supplementation may reflect mobilization of antioxida nt defenses. O 2001 Elsevier Science Inc. All rights reserved.