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Use of a Central Venous Line for Fluids, Drugs and Nutrient Administration in a Mouse Model of Critical Illness
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Published on: May 2, 2017

Selenium supplementation in the critically ill.

Gil Hardy1, Ines Hardy, William Manzanares

  • 1Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland, New Zealand. g.hardy@auckland.ac.nz

Nutrition in Clinical Practice : Official Publication of the American Society for Parenteral and Enteral Nutrition
|February 7, 2012
PubMed
Summary
This summary is machine-generated.

Selenium (Se) is vital for antioxidant and immune functions. High-dose intravenous Se therapy may improve outcomes for critically ill patients with systemic inflammatory response syndrome (SIRS) by reducing complications and mortality.

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Area of Science:

  • Biochemistry and Molecular Biology
  • Clinical Nutrition
  • Critical Care Medicine

Background:

  • Selenium (Se) is an essential trace element crucial for antioxidant, immunological, and anti-inflammatory functions, primarily through its incorporation into selenoproteins.
  • Selenoproteins are vital for redox signaling, antioxidant defense, thyroid hormone metabolism, and immune responses.
  • Dietary selenium intake varies geographically, impacting reference intakes and toxicity concerns.

Purpose of the Study:

  • To evaluate the safety and efficacy of high-dose selenium (Se) supplementation in critically ill patients with systemic inflammatory response syndrome (SIRS).
  • To assess the potential of Se status as an early predictor of survival in SIRS patients.
  • To understand the pharmacokinetics of intravenous selenite administration in the critically ill.

Main Methods:

  • Review of studies evaluating selenium supplementation (500-1600 µg/d) in critically ill patients, often involving an initial loading dose followed by continuous infusion.
  • Analysis of clinical outcomes, including illness severity, infectious complications, and mortality rates in intensive care unit (ICU) patients.
  • Examination of the pharmacokinetic profile of intravenous selenite, distinguishing between transient pro-oxidant and sustained antioxidant effects.

Main Results:

  • High-dose intravenous selenium (Se) administration appears safe and efficacious in critically ill SIRS patients.
  • Se supplementation demonstrated improvements in clinical outcomes, including reduced illness severity and infectious complications.
  • Evidence suggests a significant decrease in mortality rates among intensive care unit (ICU) patients receiving Se therapy.

Conclusions:

  • High-dose intravenous Se therapy, particularly pharmaconutrition protocols, shows promise for improving outcomes in critically ill SIRS patients.
  • Further research is needed for better biomarkers to determine optimal individual Se requirements and refine clinical practice guidelines.
  • Routine initiation of high-dose intravenous Se therapy upon ICU admission for SIRS patients is warranted based on current evidence.