A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D

  title={A review of micronutrients in sepsis: the role of thiamine, l-carnitine, vitamin C, selenium and vitamin D},
  author={Justin B. Belsky and Charles R Wira and Vinitha Jacob and John E Sather and Patty J. Lee},
  journal={Nutrition Research Reviews},
  pages={281 - 290}
Abstract Sepsis is defined as the dysregulated host response to an infection resulting in life-threatening organ dysfunction. The metabolic demand from inefficiencies in anaerobic metabolism, mitochondrial and cellular dysfunction, increased cellular turnover, and free-radical damage result in the increased focus of micronutrients in sepsis as they play a pivotal role in these processes. In the present review, we will evaluate the potential role of micronutrients in sepsis, specifically… 
Micronutrients in Sepsis and COVID-19: A Narrative Review on What We Have Learned and What We Want to Know in Future Trials
This topic is addressed, including the recent advancement in the study of vitamin D and protocols based on vitamin C and other micronutrients, to explore an update in the setting of sepsis, gain some new insights applicable to COVID-19 patients, and contribute to a pathophysiological definition of the potential role of micronsutrients.
The effects of l-carnitine supplementation on inflammatory factors, oxidative stress, and clinical outcomes in patients with sepsis admitted to the intensive care unit (ICU): study protocol for a double blind, randomized, placebo-controlled clinical trial
It is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis.
Clinical efficacy and safety of vitamin C in the treatment of septic shock patients: systematic review and meta-analysis.
Intravenous vitamin C showed no efficacy in the treatment of sepsis and did not improve the 72-h sequential organ failure assessment (72-h SOFA) score in sepsi patients.
Potential Effects of Melatonin and Micronutrients on Mitochondrial Dysfunction during a Cytokine Storm Typical of Oxidative/Inflammatory Diseases
The main findings related to the powerful effects of melatonin and some micronutrients (vitamins and minerals), which may be useful (alone or in combination) as therapeutic agents in the treatment of several examples of oxidative/inflammatory pathologies, including sepsis, as well as cardiovascular, renal, neurodegenerative, and metabolic disorders are summarized.
Efficacy of vitamin C in patients with sepsis: A updated meta-analysis.
Oxidant/Antioxidant Status Is Impaired in Sepsis and Is Related to Anti-Apoptotic, Inflammatory, and Innate Immunity Alterations
Oxidant/antioxidant status is impaired in septic compared to critically ill patients with trauma or surgery and is related to anti-apoptotic, inflammatory, and innate immunity alterations, which might be related to undefined phenotypes in patients and healthy individuals.
Evaluation of Serum Selenium Levels in Sepsis Patients Hospitalized in Tabriz
Investigating the serum level of Se in patients with sepsis in hospitals affiliated to Tabriz University of Medical Sciences can pave the way for various interventions to timely identify this complication and treatment methods to improve the condition of these patients while reducing hospital deaths.
Effect of α-tocopherol in alleviating the lipopolysaccharide-induced acute lung injury via inhibiting nuclear factor kappa-B signaling pathways
ABSTRACT Acute respiratory distress syndrome (ARDS) leads to the acute lung injury (ALI), a form of diffused alveolars injury, accompanied by severe inflammation and oxidative damage of alveolar
A Mechanistic Link Between Selenium and Coronavirus Disease 2019 (COVID-19)
It is found that oxidative stress is a characteristic feature of CO VID-19 disease, which is linked with the immunopathological disorder observed in individuals with severe COVID-19, and selenium deficiency is found to be associated with the severity of COVID -19 disease.
A meta-analysis of randomized controlled trials
In conclusion, intravenous selenium supplementation could not be suggested for routine use and was not found to be benefit for sepsis patients with reduced duration of vasopressor therapy, staying time in intensive care unit and hospital, and incidence of ventilator-associated pneumonia.


Alterations in vitamin D status and anti-microbial peptide levels in patients in the intensive care unit with sepsis
An association between critical illness and lower 25(OH)D and DBP levels in critically ill patients as compared to healthy controls is demonstrated and a positive association between vitamin D status and plasma LL-37 is established, which suggests that systemicLL-37 levels may be regulated by vitamin Dstatus.
The effect of thiamine deficiency on inflammation, oxidative stress and cellular migration in an experimental model of sepsis
TD was associated with greater bacterial clearance, oxidative stress and inflammatory response changes, and was associated in the CLP with TD chow group with significantly higher levels of TNF-α and MCP-1 concentrations.
Vitamin C fails to protect amino acids and lipids from oxidation during acute inflammation.
Thiamine supplementation in the critically ill
Thiamine deficiency should be suspected in different clinical scenarios such as severe sepsis, burns, unexplained heart failure or lactic acidosis, neurological disorder in patients with previous history of alcoholism, starvation, chronic malnutrition, long-term parenteral feeding, hyperemesis gravidarum, or bariatric surgery.
Antioxidant Vitamins and Trace Elements in Critical Illness.
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It remains unclear whether supplementation of antioxidant micronutrients has any clinical benefit in critically ill patients as some studies show clear benefits, whereas others demonstrate neutral outcomes and even harm.
Vitamin C requirements in parenteral nutrition.
On the basis of available pharmacokinetic data the 100 mg/d dose for patients receiving home PN and 200mg/d for stable adult patients receiving PN are adequate, but requirements have been shown to be higher in perioperative, trauma, burn, and critically ill patients, paralleling oxidative stress.
Effect of 1,25-dihydroxy-vitamin D3 in experimental sepsis
A positive modulating effect of 1,25-dihydroxy-vitamin D3 supplementation on sepsis-induced coagulation disturbances in the coecal ligation and puncture model is suggested and no significant differences between vitamin D and placebo-treated rats with regards to liver function are found.
Randomized controlled trial of calcitriol in severe sepsis.
Calcitriol administration did not increase plasma cathelicidin protein levels in critically ill patients with sepsis and had mixed effects on other immunomodulatory markers.
Ascorbate-dependent vasopressor synthesis: a rationale for vitamin C administration in severe sepsis and septic shock?
It is conceivable that administration of ascorbate to septic patients with hypovitaminosis C could improve endogenous vasopressor synthesis and thus ameliorate the requirement for exogenously administered vasopressors.
Vitamin C and Immune Function
Prophylactic prevention of infection requires dietary vitamin C intakes that provide at least adequate, if not saturating plasma levels, and treatment of established infections requires significantly higher doses to compensate for the increased inflammatory response and metabolic demand.