Impact of zinc supplementation on cellular and molecular biomechanical alterations and critical outcomes in pediatric patients with sepsis: A randomized controlled trial

Abstract

Background: Sepsis remains a significant contributor to illness and death in children. Studies suggests that potential benefits of zinc supplementation in patients with sepsis, such as reduced inflammation and mortality rates. Zinc is involved in maintaining the structural integrity and function of cell membranes, which is essential for proper cell signaling and biomechanical responses. It can also influence the activity of key enzymes and proteins that regulate intracellular and extracellular forces, thereby affecting cell adhesion, migration, and overall tissue mechanics. Therefore, this study aimed to evaluate the occurrence of Acute Respiratory Distress Syndrome (ARDS), Septic Shock, Acute Kidney Injury (AKI), and Mortality in Pediatric Sepsis receiving Zinc supplementation, with a focus on the underlying cellular and molecular biomechanical mechanisms. Methods: This study was a Randomized Control Trial (RCT) conducted using a parallel-group, double-blind design and prospective cohort approach. Participants were selected through consecutive sampling and then randomized into two groups: one receiving standard therapy plus zinc supplementation and the other receiving standard therapy plus a placebo. Results: Among pediatric patients with sepsis, the incidence of septic shock was significantly lower in the group receiving standard therapy with zinc supplementation (34.4%) compared to the placebo group (65.6%) (p = 0.00, OR 2.29, 95% CI: 1.28–4.11). The incidence of ARDS was 66.7% in the placebo group, versus 33.3% in the zinc group (p = 0.00, OR 0.37, 95% CI: 0.22–0.64). For acute kidney injury (AKI), 65.7% occurred in the placebo group compared to 34.3% in the zinc group (p = 0.04, OR 2.09, 95% CI: 0.99–4.40). Mortality in the placebo group was 64.3%, while in the zinc group it was 35.7% (p = 0.01, OR 0.48, 95% CI: 0.26–0.88). Conclusion: Zinc supplementation significantly reduces the incidence of acute respiratory distress syndrome, acute kidney injury, septic shock, and mortality in pediatric patients with sepsis. These outcomes may be attributed to zinc’s role in modulating cellular signaling pathways, enhancing cellular integrity under stress, and improving the biomechanical properties of cell membranes, thereby promoting better physiological responses in the context of sepsis.

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