| Summary: | Objetivos: Estudiar, en pacientes críticos, la respuesta de los niveles de Zn en plasma (ZnPl), de IL-6 sérica, del IL-6sR y de la PCR en relación al Zn administrado en la NPT, para evitar la deficiencia o el exceso de Zn. Métodos: 17 pacientes que recibieron NPT, por pancreatitis aguda o luego de una cirugía abdominal mayor. Al inicio (To) y a la finalización (Tf) de la NPT (6 a 21 días) se determinó en suero: IL-6 y IL-6 sR (ELISA); PCR (inmunoturbidimetría); ZnPl y Zn en NPT (Espectrometría de Absorción Atómica). Características físicas: edad, años (promedio ± DE y rangos): 60,6 ± 11,7 (37-77); BMI (kg/m²): 26,0 ± 3,4 (19,9-34,0). Resultados: Promedio ± DE (y rangos): aporte de Zn en la NPT: 6,1 ± 2,0 mg/día (2,8 a 10,8); parámetros bioquímicos, a To y Tf, respectivamente: Zn Pl (μg/dl): 104 ± 46 (35-177); 120 ± 55 (52-229); IL-6 (pg/mL) 93 ± 74 (10-262); 117 ± 180 (7-761); IL6sR (pg/mL): 1012 ± 322 (589-1.855); 1.269 ± 451 (631-2.195); PCR (mg/L): 71 ± 63 (2-196); 65 ± 43 (0-137). Dos pacientes, que fallecieron, incrementaron más de 4 veces los niveles de IL6, mantuvieron altos niveles de IL-6sR, pero disminuyendo los de PCR, recibiendo 4,2 y 5,2 mg/d de Zn. El 60% de los pacientes con evolución clínica favorable presentó una disminución de los niveles de IL6. Conclusiones: en los pacientes críticos, con evolución favorable, dosis de Zn de 2,8 a 10,8 mg/d en la NPT no exacerbaron la respuesta inflamatoria, evaluada mediante los niveles de IL-6, IL6sR y PCR.<br>Objectives: To study the interrelationship between serum Interleukin-6 (IL-6), serum Interleukin-6 soluble Receptor (IL-6 sR), C-Reactive Protein (C-RP), plasmatic Zinc levels (PlZn) and their response in relation to Zn administered by TPN, in critical patients. Methods: 17 patients, receiving TPN as a consequence of acute pancreatitis (n = 4) or after a major abdominal surgery due to intestinal cancer (n = 7), intestinal fístula (n = 3), intestinal obstruction (n = 2) or intestinal íleus (n = 1) were studied. At the beginning (To) and at the end of the TPN administration (6-21days) serum IL-6 and IL-6 sR were determined by ELISA; C-RP ultrasensitive (C-RP us) by inmunoturbidimetric method; Zn was determined in TPN and in plasma by Atomic Absorption Spectrometry. Characteristics of the patients were (mean ± SD and ranges): age: 60.6 ± 11.7 (37-77) years; BMI (kg/m²): 26.0 ± 3.4 (19.9-34.0). Results: The results (mean ± standard deviation and ranges) were: Zn provided by TPN (mg/d): 6.1 ± 2.0 (range 2.8 to 10.8). Biochemical levels were, at To and Tf, respectively: (mean±SD and ranges) were at To y Tf, respectively: Zn Pl (μg/dl): 104 ± 46 (35-177); 120 ± 55 (52-229); IL-6 (pg/mL) 93 ± 74 (10-262); 117 ± 180 (7-761); IL6sR (pg/mL): 1,012 ± 322 (589-1855); 1,269 ± 451 (631-2195); C-RP us (mg/L): 71 ± 63 (2-196); 65 ± 43 (0-137). There was no correlation between variations of IL6, IL6sR, C-RP, PlZn levels and the daily amount of Zn administered in the TPN mixtures. Two patients presented a bad evolution; they received 4.2 and 5.2 md/d of Zn and showed an increase of IL6 levels, maintained high levels of IL6sR but C-RP levels decreased. Conclusions: the range of 2.8 to 10.8 mg/d of Zn administered in TPN mixtures did not exacerbate the inflammatory response.
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