Selenium supplementation in critically ill patients: a systematic review and meta-analysis

Area of Science:

• Critical care medicine
• Nutritional biochemistry
• Oxidative stress research

Background:

• Oxidative stress is prevalent in critical illness, yet antioxidant therapy efficacy remains debated.
• Selenium plays a crucial role in antioxidant defense mechanisms.

Purpose of the Study:

• To evaluate the impact of intravenous selenium supplementation on antioxidant status, infection, organ failure, and outcomes in critically ill patients.
• To assess selenium's potential as a protective agent against complications in critical illness.

Main Methods:

• Systematic review and meta-analysis of randomized controlled trials (RCTs).
• Comparison of selenium supplementation versus standard care in adult critically ill patients.
• Inclusion of nine RCTs meeting predefined criteria.

Main Results:

• Selenium supplementation showed a borderline statistically significant reduction in 28-day mortality (RR 0.84, P = .04).
• No significant effects were observed in subgroup analyses for dose, administration, or treatment duration.
• No improvements noted in hospital length of stay, pulmonary infections, or renal failure.

Conclusions:

• High-dose selenium supplementation may be linked to improved 28-day survival in critically ill individuals.
• Further investigation is required to establish selenium's role as an effective adjuvant therapy in critical care settings.