Invited Review Antioxidant Micronutrients in Major Trauma and Burns: Evidence and Practice

ABSTRACT: There has been a growing interest in micro-nutrients as a result of their essential role in endogenous antioxidant defense mechanisms and immunity. Critically ill burn and trauma patients are characterized by an increased free radical production, which is proportional to the severity of the injury. In addition, they are at high risk of negative trace element balances, which contribute to the imbalance in endogenous antioxidant capacity and the extension of primary lesions. Although selenium, zinc, and vitamin C and E status are altered in all injured patients, patients with major burns are unique for having copper deficiency. In major burns, high-dose ascorbic acid for 24 hours achieves reduction of resuscitation fluid require-ments by endothelial antioxidant mechanisms both in animal models and in 1 human trial. Supplementatio