Effect of selenium supplementation on biochemical markers and outcome in critically ill patients.
OBJECTIVE
This study aimed to assess the effect of high dose selenium (Se) supplementation on Se status in blood, oxidative stress, thyroid function and possible effects on requirement for renal replacement therapy (RRT) in severely septic patients admitted to the intensive care unit (ICU).


METHODS
This prospective single-centre study was carried out in 40 septic ICU patients who were randomized to high dose Se (Se+ group, N=18 (474, 316, 158 microg/day), each for 3 consecutive days followed by a standard dose of 31.6 microg/day of Se given as sodium selenite whereas the control group (Se-, N=22) received only the standard dose of Se. Plasma Se, glutathione peroxidase (GSH-Px), F2 isoprostanes, thyroid function tests (total T4 and total T3), C-reactive protein (CRP) and red blood cell (RBC) GSH-Px were estimated on day 0, 3, 7, 14.


RESULTS
In the Se+ group, plasma Se increased by day 3 and 7 (P<0.0001) and day 14 (P=0.02), plasma GSH-Px increased by day 3 and 7 (P=0.01) as compared to Se- group. There was a significant negative correlation between plasma Se and SOFA (sepsis related organ failure assessment) (r=-0.36, P=0.03) along with low plasma Se and high CRP at the time of admission. Requirement for renal replacement therapy was not significantly different between the groups.


CONCLUSIONS
Although high dose Se supplementation increased plasma Se and GSH-Px activity, it did not reduce oxidative damage or the requirement for RRT. Se levels in blood are influenced by redistribution and severity of illness and therefore should be interpreted with caution.
Mishra
Vinita
V
Department of Clinical Chemistry, Royal Liverpool University Hospital, Liverpool L69 3GA, UK. vinmishra@yahoo.co.uk
Baines
Malcolm
M
Perry
Sara Elizabeth
SE
McLaughlin
Paul Jeremy
PJ
Carson
Jeff
J
Wenstone
Richard
R
Shenkin
Alan
A
D000368:Aged; D000975:Antioxidants / Q000378:metabolism / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D016638:Critical Illness / Q000628:therapy*; D019587:Dietary Supplements; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004912:Erythrocytes / Q000201:enzymology; D005260:Female; D005979:Glutathione Peroxidase / Q000378:metabolism; D006801:Humans; D007362:Intensive Care Units; D007668:Kidney / Q000187:drug effects / Q000502:physiology; D008297:Male; D009102:Multiple Organ Failure / Q000453:epidemiology; D009751:Nutritional Requirements; D018384:Oxidative Stress / Q000187:drug effects; D011446:Prospective Studies; D017582:Renal Replacement Therapy; D012643:Selenium / Q000097:blood / Q000627:therapeutic use; D018805:Sepsis / Q000097:blood / Q000628:therapy*; D012720:Severity of Illness Index; D013961:Thyroid Gland / Q000187:drug effects / Q000502:physiology; D016896:Treatment Outcome
D000975:Antioxidants; D015415:Biomarkers; D002097:C-Reactive Protein; D005979:Glutathione Peroxidase; D012643:Selenium