Does early administration of selenium improve neurological outcome after cardiac arrest?
OBJECTIVE
Existing data indicate that selenium supplementation may be beneficial in critically ill patients and in those with ischemic stroke. The purpose of this retrospective study was to explore the influence of early administration of selenium on neurological outcome after cardiopulmonary resuscitation (CPR).


METHODS
We examined 227 consecutive unconscious patients after CPR and excluded 1 individual. The decision to administer selenium was left to the discretion of the attending physician, resulting in 124 patients (55%) who received intravenous selenium (200-1000 microg/d) for a median of 5 days after CPR. Patients were classified according to the best Glasgow-Pittsburgh cerebral performance categories (CPCs 1-5) achieved within 6 months of follow-up.


RESULTS
The rate of regaining consciousness (CPC 1-3) after CPR was 58%. Multivariable logistic regression analysis confirmed a shockable first monitored rhythm (adjusted odds ratio, 3.73; 95% confidence interval, 1.85-7.52; P < .001), time to return of spontaneous circulation (adjusted odds ratio, 0.94; 95% confidence interval, 0.91-0.96; P < .001), administration of selenium (adjusted odds ratio, 2.38; 95% confidence interval, 1.19-4.76; P = .014), and the Simplified Acute Physiology Score II (adjusted odds ratio, 0.96; 95% confidence interval, 0.93-0.99; P = .034) as independent predictors of regaining consciousness after CPR. Survival at 6 months of follow-up was not improved significantly by selenium.


CONCLUSIONS
This retrospective analysis leads to the hypothesis that early administration of selenium may improve neurological outcome after cardiac arrest.
Department of Internal Medicine/Cardiology, Krankenhaus Barmherzige Schwestern, 4010 Linz, Austria. johann.reisinger@bhs.at
Johann
J
Reisinger
Kurt
K
Höllinger
Wolfgang
W
Lang
Christoph
C
Steiner
Thomas
T
Winter
Andreas
A
Winter
Michael
M
Mori
Alexander
A
Lindorfer
Daniel
D
Kiblböck
Peter
P
Siostrzonek
D000368:Aged; D016887:Cardiopulmonary Resuscitation; D002493:Central Nervous System Diseases / Q000517:prevention & control; D016009:Chi-Square Distribution; D005260:Female; D006323:Heart Arrest / Q000188:drug therapy*; D006801:Humans; D007262:Infusions, Intravenous; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012643:Selenium / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome; D014474:Unconsciousness
D012643:Selenium