Published January 30, 2024
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ESPEN practical short micronutrient guideline.

  • 1. Faculty of Biology & Medicine, Lausanne University, Lausanne, Switzerland. Electronic address: Mette.Berger@unil.ch.
  • 2. Institute of Aging and Chronic Disease, University of Liverpool, Liverpool, UK. Electronic address: shenkin@liverpool.ac.uk.
  • 3. University of Liverpool
  • 4. Department of Internal Medicine and Clinical Nutrition Unit, University of Health Sciences Kayseri City Training and Research Hospital, Kayseri, Turkey. Electronic address: oguzhansitki.dizdar@sbu.edu.tr.
  • 5. Medical University of Graz, Department of Internal Medicine, Division of Endocrinology and Diabetology, Austria. Electronic address: karin.amrein@medunigraz.at.
  • 6. University Centre of Legal Medicine Lausanne-Geneva, Lausanne University Hospital and University of Lausanne, Geneva University Hospital and University of Geneva, Lausanne-Geneva, Switzerland. Electronic address: Marc.Augsburger@chuv.ch.
  • 7. University of Geneva
  • 8. University of Lausanne
  • 9. Institute of Nutritional Science, University of Hohenheim, Stuttgart, Germany. Electronic address: hans-k.biesalski@uni-hohenheim.de.
  • 10. Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany. Electronic address: bischoff.stephan@uni-hohenheim.de.
  • 11. KU Leuven, Department of Cellular and Molecular Medicine, Laboratory of Intensive Care Medicine, Leuven, Belgium. Electronic address: michael.casaer@uzleuven.be.
  • 12. Katholieke Universiteit Leuven
  • 13. Division of Intensive Care Medicine, Department of Internal Medicine, Erciyes University School of Medicine, Kayseri, Turkey. Electronic address: kursatgundogan@gmail.com.
  • 14. North Estonia Regional Hospital, Tallinn, Estonia. Electronic address: liis.lepp@gmail.com.
  • 15. Department of Intensive Care Medicine, Research VUmc Intensive Care (REVIVE), Amsterdam Cardiovascular Science (ACS), Amsterdam Infection and Immunity Institute (AI&II), Amsterdam Medical Data Science (AMDS), Amsterdam UMC, Vrije Universiteit Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, the Netherlands. Electronic address: ame.deman@amsterdamumc.nl.
  • 16. VU University Amsterdam
  • 17. Dipartimento di Medicina Clinica e Chirurgia, Sezione di Endocrinologia, Università di Napoli (Federico II), Naples, Italy; United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair for Health Education and Sustainable Development, Federico II University, Naples, Italy. Electronic address: giovanna.muscogiuri@gmail.com.
  • 18. Pharmacy Department, Stanley Dudrick's Memorial Hospital, Skawina, Poland. Electronic address: magpietka@gmail.com.
  • 19. Department of Medical and Surgical Sciences, University of Bologna, Italy; Centre for Chronic Intestinal Failure, IRCCS AOUBO, Bologna, Italy. Electronic address: Loris.pironi@unibo.it.
  • 20. Scientific Institute for Research, Hospitalization and Healthcare
  • 21. University of Bologna
  • 22. Swiss Nutrition and Health Foundation, Epalinges, Switzerland. Electronic address: serge.rezzi@nutritionhealthfoundation.ch.
  • 23. Institute of Nutritional Medicine, University of Hohenheim, Stuttgart, Germany. Electronic address: anna.schweinlin@uni-hohenheim.de.
  • 24. Departamento de Medicina, Universidad Complutense de Madrid, Nutrition Unit, Hospital General Universitario Gregorio Marañón, Madrid, Spain. Electronic address: cuerda.cristina@gmail.com.
  • 25. Complutense University of Madrid

Description

Trace elements and vitamins, named together micronutrients (MNs), are essential for human metabolism. The importance of MNs in common pathologies is recognized by recent research, with deficiencies significantly impacting the outcome. This short version of the guideline aims to provide practical recommendations for clinical practice. An extensive search of the literature was conducted in the databases Medline, PubMed, Cochrane, Google Scholar, and CINAHL for the initial guideline. The search focused on physiological data, historical evidence (for papers published before PubMed release in 1996), and observational and/or randomized trials. For each MN, the main functions, optimal analytical methods, impact of inflammation, potential toxicity, and provision during enteral or parenteral nutrition were addressed. The SOP wording was applied for strength of recommendations. The limited number of interventional trials prevented meta-analysis and led to a low level of evidence for most recommendations. The recommendations underwent a consensus process, which resulted in a percentage of agreement (%): strong consensus required of >90 % of votes. Altogether the guideline proposes 3 general recommendations and specific recommendations for the 26 MNs. Monitoring and management strategies are proposed. This short version of the MN guideline should facilitate handling of the MNs in at-risk diseases, whilst offering practical advice on MN provision and monitoring during nutritional support. Copyright © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.
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