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[Selenium administration in sepsis patients]

R Gärtner1, M W Angstwurm, J Schottdorf

  • 1Klinikum Innenstadt, Universität München.

Medizinische Klinik (Munich, Germany : 1983)
|January 7, 1998
PubMed
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Selenium supplementation in critically ill patients with inflammatory response syndrome improved clinical outcomes and reduced acute renal failure. This intervention normalized selenium levels and glutathione peroxidase activity, suggesting a therapeutic benefit.

Area of Science:

  • Critical Care Medicine
  • Nutritional Biochemistry
  • Clinical Nutrition

Background:

  • Low serum selenium concentrations and glutathione peroxidase activity are linked to poor outcomes in critically ill patients.
  • This may result from impaired free radical scavenging, potentially worsening clinical status.

Purpose of the Study:

  • To investigate the impact of selenium substitution on clinical outcomes in patients with inflammatory response syndrome and severe illness.
  • To assess the effect of selenium on acute renal failure, respiratory insufficiency, and mortality rates.

Main Methods:

  • A controlled, prospective study involved 42 patients with inflammatory response syndrome and APACHE-II score ≥ 15.
  • Patients received either standard care (Se-, n=21) or selenium substitution (Se+, n=21) with additional sodium selenite.

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  • Clinical outcomes were monitored using APACHE-III scores, incidence of acute renal failure, respiratory insufficiency, and mortality.

    • Main Results:

    • Selenium substitution normalized serum selenium levels and glutathione peroxidase activity.
    • The selenium group showed significant improvement in APACHE-III scores on days 7 and 14.
    • A significant reduction in acute renal failure incidence was observed in the selenium group (3 vs. 9 patients).
    • Mortality was reduced in the selenium group, particularly in patients with APACHE-II scores > 20 (30% vs. 70%).

    Conclusions:

    • Selenium substitution significantly improves clinical outcomes in critically ill patients with inflammatory response syndrome.
    • Supplementation with selenium effectively reduces the incidence of acute renal failure and may lower mortality rates.