Authors: Dyah Kanya Wati, Lanang Sidiartha, Ketut Tunas, Andrie Setiawan
Objective: Critical conditions arise when there is a threat or ongoing organ failure that disrupts the balance of the body’s oxygen and physiological needs. Patients often require help, such as endotracheal intubation procedures, mechanical ventilation, and renal or liver replacement therapy, in place of impaired organ function. Usually, complications are more common in children than in adults. Zinc is one of the micronutrients that plays a vital role as an antioxidant and the role of defense immune modulators against systemic inflammatory response syndrome (SIRS). Outcome patient with ventilator depends on SIRS response to the disease. Meanwhile the study about zinc supplementation in Pediatric Intensive Care Unit (PICU) is limited. The main objective of this study was to look at the correlation of plasma zinc levels with inflammatory responses in children of 1-12 years old with ventilator in pediatric intensive care unit.
Design and setting: This study was prospective study in Sanglah General Hospital, Denpasar and was calculated by Pearson analysis to determine the correlation of variables plasma zinc with levels of pro-inflammatory cytokines interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-α) and continued by general linier model analysis.
Results: More than 70% sample was insufficiency zinc for the first 24 hours and after 72 hours, respectively. Correlation between plasma zinc and pro-inflammatory cytokines were TNF-α; p<0.001 r: -0.91, and IL-6; p=0.013, r: -0.48 in 24 hours, and IL-6; p>0.05 r: 0.011, and TNF-α; p<0.01 r: 0.659 in 72 hours.
Conclusions: There were significant correlation in TNF-α and IL-6 measurement between zinc plasma insufficiency with pro-inflammatory cytokines in the first 24 hours and significant correlation in TNF-α in 72 hours. Therefore, zinc supplementation in 72 hours from patient admission to PICU may have important role to reduce morbidity in PICU.