Publication:

Nutrient deficiencies (Copper, Zinc, Iron, Magnesium) among children with SIRS/sepsis-a hospital based cross sectional study

Background In developing countries sepsis is a major etiological factor contributing to 60-80 % of annual mortality. SIRS/sepsis rates are high among children admitted to hospitals particularly in intensive care units. Oxidative stress plays important role in etio-pathogenesis of SIRS/sepsis. Nutrients with antioxidant activity enhance immune system there by decreasing severity of SIRS/sepsis. Estimation of such nutrient levels might establish relationship with oxidative stress in children with SIRS/sepsis.

Methods A hospital based cross-sectional study was done on consecutive samples of 96 children diagnosed with SIRS/sepsis. Serum copper, iron zinc, magnesium levels of children diagnosed with sepsis/SIRS included in the study were estimated, data were represented as median with inter quartile range and proportions. Mann Whitney u test and Karl Pearson’s correlation tests were used to see correlation between clinical paramaters.

Results Zinc and magnesium deficiency were seen in 68.8% and 59.4% children with SIRS/sepsis. Median serum magnesium levels were 1.24mg/dL in children with illness 1week duration prior to hospitalization (p=0.017). Hospital acquired infections were higher with zinc (P=0.001) and copper deficiency(P=0.002). Zinc deficiency correlated with need for longer hospitalization (P= 0.017).  Mortality due to SIRS/sepsis increased as number of nutrient deficiencies increased (P =0.009).

Conclusions Significant number of children with SIRS/sepsis had nutrient deficiencies. These deficiencies correlated significantly with duration of illness prior to hospitalization. Children with nutrient deficiency had higher incidence of hospital acquired infections. Children with normal nutrient levels have decreased length of hospitalization. Children with multiple nutrient deficiency had higher risk of death.