title: A large-bolus injection, but not continuous infusion of sodium selenite improves outcome in peritonitis.
abstract: Administration of sodium selenite in septic shock has been associated with apparently conflicting results that may be related to different dosing schedules. Bolus administration, leading to a transient pro-oxidative effect, could limit the inflammatory reaction and improve outcomes. We studied 21 anesthetized, mechanically ventilated, invasively monitored, and fluid-resuscitated sheep. Nine hours after inducing peritonitis by injection of autologous feces, the animals were randomized into three groups: (i) bolus injection (2 mg selenium as selenite, followed by 0.06 microg . kg-1 . h-1, n = 7); (ii) continuous infusion (4 microg . kg-1 . h-1 selenium, n = 7), or (iii) control (n = 7). No vasopressors or antibiotics were administered. All animals were monitored until spontaneous death. Peak plasma selenium values reached 4 to 14 micromol . L-1. Compared with the other groups, sheep given a bolus of sodium selenite had delayed hypotension with better maintained cardiac index, delayed hyperlactatemia, fewer sepsis-induced microvascular alterations, and a prolonged survival time (21.9 [bolus group] vs. 18.4 [continuous group] and 18.3 h [control group], P < 0.05). Hence, in this model of septic shock, the administration of a large bolus of sodium selenite (rather than a continuous administration) resulted in beneficial effects, probably by a transient oxidative effect.
authors: Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles, Belgium.
authors: Zhen
authors: Z
authors: Wang
authors: Xavier
authors: X
authors: Forceville
authors: Pierre
authors: P
authors: Van Antwerpen
authors: Michael
authors: M
authors: Piagnerelli
authors: David
authors: D
authors: Ahishakiye
authors: Pascale
authors: P
authors: Macours
authors: Daniel
authors: D
authors: De Backer
authors: Jean
authors: J
authors: Neve
authors: Jean-Louis
authors: JL
authors: Vincent
mesh_terms: D000818:Animals; D005260:Female; D007022:Hypotension / Q000097:blood / Q000188:drug therapy / Q000473:pathology; D010084:Oxidation-Reduction / Q000187:drug effects; D010538:Peritonitis / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D012756:Sheep; D018038:Sodium Selenite / Q000097:blood / Q000494:pharmacology*; D013997:Time Factors
chemical_list: D018038:Sodium Selenite