What is the serum sulfur level after intubation (invasive mechanical ventilation)?

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From the Guidelines

Monitoring sulfur serum levels after intubation is not a standard clinical practice and is not recommended. The provided evidence does not support the measurement of sulfur levels in patients following intubation procedures 1. Intubation, which involves placing a tube into the trachea to maintain an open airway, does not typically affect sulfur metabolism in a clinically significant way that would warrant monitoring. Instead, clinicians typically monitor:

  • Oxygen saturation
  • Carbon dioxide levels
  • Electrolytes
  • Acid-base balance in intubated patients. If there is concern about metabolic disturbances in critically ill intubated patients, standard laboratory tests would include:
  • Arterial blood gases
  • Complete metabolic panel
  • Complete blood count
  • Specific tests based on the underlying condition. Sulfur is present in the body primarily as part of amino acids (methionine and cysteine) and certain vitamins, but isolated sulfur levels are not routinely measured in clinical practice. The focus after intubation should be on managing the patient's respiratory and cardiovascular status, as outlined in the guidelines for intubation and extubation of the ICU patient 1.

The guidelines suggest that a protocol for intubation including a respiratory component should probably be used in ICU to decrease respiratory complications, and a post-intubation recruitment manoeuvre should probably be used in ICU in hypoxaemic patients 1. Additionally, a PEEP of at least 5 cmH2O should probably be applied after intubation of hypoxaemic patients, and a cardiovascular component should probably be included in the protocol during intubation of ICU patients 1. These recommendations prioritize the patient's morbidity, mortality, and quality of life, and do not include monitoring of sulfur serum levels.

From the Research

Sulfur Serum Level Post Intubation

  • There is no direct evidence in the provided studies to suggest a specific sulfur serum level post intubation.
  • The studies focus on the importance of sulfur in human nutrition, its applications in medicine, and its role in various biochemical functions 2, 3, 4.
  • Sulfur is an essential element for all animal species, and its deficiency can occur mainly when plants are grown in sulfur-depleted soils and when humans and animals consume low-protein diets 4.
  • The metabolism of sulfur-containing amino acids in the liver is crucial, and abnormalities in sulfur metabolism can lead to liver disease 5.
  • In critical care situations, such as severe sepsis and acute renal failure, factors like pharmacokinetics, weight, and residual renal function should be considered when prescribing antibiotic regimens, but there is no mention of sulfur serum levels 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Sulfur in human nutrition and applications in medicine.

Alternative medicine review : a journal of clinical therapeutic, 2002

Research

Nutrition and sulfur.

Advances in food and nutrition research, 2021

Research

Sulfur: its clinical and toxicologic aspects.

Nutrition (Burbank, Los Angeles County, Calif.), 2003

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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