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Time course and relationship between plasma selenium concentrations, systemic inflammatory response, sepsis, and
1Department of Anesthesiology and Intensive Care, Friedrich-Schiller-University Jena, Germany.
British Journal of Anaesthesia
|May 5, 2007
Summary
Critically ill patients often have low plasma selenium levels, which decrease further with organ failure and infection. Lower selenium predicts worse outcomes and higher ICU mortality.
Area of Science:
- Critical care medicine
- Nutritional biochemistry
- Clinical pathology
Background:
- Selenium is vital for acute illness defense.
- Investigated plasma selenium in intensive care unit (ICU) patients.
- Examined selenium's relation to systemic inflammatory response syndrome (SIRS), organ dysfunction, infection, and ICU outcomes.
Purpose of the Study:
- To determine the time course of plasma selenium concentrations in ICU patients.
- To assess the relationship between plasma selenium and SIRS, organ dysfunction, infection, and patient outcomes.
- To identify selenium's role in critically ill surgical patients.
Main Methods:
- Daily measurement of plasma selenium and laboratory indices in 60 ICU patients.
- Patients categorized into four groups: ICU controls, uncomplicated SIRS, severe SIRS, and severe sepsis/septic shock.
- Analysis of correlations between selenium levels and clinical indicators and outcomes.
Main Results:
- 92% of patients had below-normal selenium levels.
- Selenium decreased during ICU stay, especially in patients with organ failure and infection.
- Minimum selenium levels inversely correlated with disease severity scores and positively with platelet and antithrombin activity.
- Low selenium and high SAPS II scores were strong predictors of ICU mortality.
Conclusions:
- Critically ill surgical patients typically exhibit low plasma selenium.
- Greater selenium decrease observed in patients with organ failure, particularly with infection.
- Lower selenium concentrations correlate with increased tissue damage, organ dysfunction, and higher ICU mortality.
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