Abstract

Micronutrients in the form of vitamins, minerals and trace elements has important role in critical care illness besides supplementation of macronutrients either in parenteral or enteral nutrition. It is unclear whether micronutrient deficiency develops, worsens, or resolves during ICU admission without supplementation.

Malnutrition associated with critical illness is the result of abnormal nutrient processing metabolic derangement as they are important co factor of the oxidative process in macronutrients metabolism. The daily vitamins and trace elements requirements have not been identified in critical ill patients and they probably vary with each patient but they are likely to be higher than the recommended daily doses of a normal adult. Low blood micronutrients levels can precede more serious clinical manifestation and may also indicate drug- nutrient interaction.

Timely administration of vitamins, minerals and trace elements in critically ill patient along the macronutrients may circumvent some acute effects like refeeding syndrome as well as the chronic consequence like critical care neuropathy and/or critical care myopathy. Conversely, widespread use of nutrients supplements leading to nutrient toxicities also not rare.

Judicial use of micronutrients along with macronutrients is crucial in treating critically ill patients and plays significant prognostic effects on morbidity and mortality.