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[Septic shock and selenium administration].

X Forceville1, P Aouizerate, M Guizard

  • 1Centre Hospitalier de Meaux, 6-8 rue Saint-Fiacre, BP 218, 77104 Meaux, France.

Therapie
|March 7, 2002
PubMed
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Selenium, an essential trace element, is crucial for enzyme activity and reactive oxygen species detoxification. In septic shock patients, selenium levels decrease, and supplementation shows promise, though further research is needed for optimal dosing.

Area of Science:

  • Biochemistry
  • Trace Element Metabolism
  • Enzymology

Context:

  • Selenium is an essential trace element vital for antioxidant enzyme function, including glutathione peroxidases and thioredoxin reductase.
  • In septic shock, excessive reactive oxygen species contribute to tissue damage, while plasma selenium levels significantly decrease.
  • The role of selenium in mitigating oxidative stress and its impact on inflammatory pathways in sepsis is an area of active investigation.

Purpose:

  • To review the role of selenium in the context of sepsis and septic shock.
  • To examine the evidence for selenium supplementation in managing severe infections and associated oxidative stress.
  • To provide recommendations for selenium administration in critically ill patients based on current literature.

Summary:

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  • Selenium, as selenocysteine, is integral to antioxidant enzymes that detoxify reactive oxygen species (ROS).
  • Septic shock patients exhibit early and marked plasma selenium depletion, potentially due to redistribution for metabolic needs.
  • While preliminary studies suggest selenium treatment may be beneficial in severe sepsis, robust clinical data is lacking, necessitating cautious dosing within physiological limits.

Impact:

  • Understanding selenium's role in sepsis can inform therapeutic strategies to combat oxidative stress and improve patient outcomes.
  • Further well-designed clinical trials are required to establish optimal selenium dosage and efficacy in septic patients.
  • This review highlights the potential of selenium as an adjunctive therapy in critical care settings, emphasizing the need for evidence-based guidelines.