A meta-analysis of randomized controlled trials

Li, Shaojun; Tang, Tian; Guo, Pengfei; Zou, Qing; Ao, Xiaoxiao; Hu, Lan; Tan, Liping

doi:10.1097/md.0000000000014733

Cited by 21 publications

(7 citation statements)

References 31 publications

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“…The most recent meta-analysis, including 13 RCTs comparing intravenous selenium and placebo in septic patients, failed to detect an association of selenium treatment with decreased mortality. Selenium supplementation was associated with earlier shock reversal and less ventilator-associated pneumonia, but did not decrease the incidence of renal failure, secondary infection, or duration of mechanical ventilation [77].…”

Section: Seleniummentioning

confidence: 81%

Nutrition in Sepsis: A Bench-to-Bedside Review

2020

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Nutrition therapy in sepsis is challenging and differs from the standard feeding approach in critically ill patients. The dysregulated host response caused by infection induces progressive physiologic alterations, which may limit metabolic capacity by impairing mitochondrial function. Hence, early artificial nutrition should be ramped-up and emphasis laid on the post-acute phase of critical illness. Caloric dosing is ideally guided by indirect calorimetry, and endogenous energy production should be considered. Proteins should initially be delivered at low volume and progressively increased to 1.3 g/kg/day following shock symptoms wane. Both the enteral and parenteral route can be (simultaneously) used to cover caloric and protein targets. Regarding pharmaconutrition, a low dose glutamine seems appropriate in patients receiving parenteral nutrition. Supplementing arginine or selenium is not recommended. High-dose vitamin C administration may offer substantial benefit, but actual evidence is too limited for advocating its routine use in sepsis. Omega-3 polyunsaturated fatty acids to modulate metabolic processes can be safely used, but non-inferiority to other intravenous lipid emulsions remains unproven in septic patients. Nutrition stewardship, defined as the whole of interventions to optimize nutritional approach and treatment, should be pursued in all septic patients but may be difficult to accomplish within a context of profoundly altered cellular metabolic processes and organ dysfunction caused by time-bound excessive inflammation and/or immune suppression. This review aims to provide an overview and practical recommendations of all aspects of nutritional therapy in the setting of sepsis.

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Section: Seleniummentioning

confidence: 81%

Nutrition in Sepsis: A Bench-to-Bedside Review

2020

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“…Selenium supplementation has therefore been largely studied. Recent studies demonstrate that if selenium administration does not reduce 28-day mortality and duration of mechanical ventilation (Bloos et al, 2016;Kong et al, 2013;Li et al, 2019;Manzanares et al, 2016), it reduces the duration of vasopressor therapy (Chelkeba et al, 2015;Li et al, 2019). The beneficial effect of selenium supplementation in septic patients is still subject to debate and further investigations are needed to understand its involvement.…”

Section: Introductionmentioning

confidence: 99%

Can selenium‐enriched spirulina supplementation ameliorate sepsis outcomes in selenium‐deficient animals?

et al. 2021

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“…Antiviral effects of selenium have been reported previously, and multiple cellular and viral mechanisms involving selenium and selenoproteins may influence viral pathogenicity, including virally encoded selenium-dependent glutathione peroxidases. Furthermore, a meta-analysis consisting of a total of 13 RCTs comparing selenium and placebo for patients with sepsis were reported [37]. The analyses could not detect the association of selenium treatment with a decreased mortality at different time courses.…”

Section: Selenium Deficiency In Dialysis Patientsmentioning

confidence: 99%

Trace Elements and Their Management in Dialysis Patients—Pathophysiology and Clinical Manifestations

Wakino

2023

Kidney and Dialysis

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Recently, as the number of elderly dialysis patients has been increasing, complications associated with low nutritional status such as infectious disease have had a strong influence on the prognosis of dialysis patients. Nutritional disorders are caused by the inadequate intake of the three major nutrients—proteins, fats, and carbohydrates—as well as vitamin and mineral deficiencies. Minerals are composed of various elements, including small-amount elements and trace elements, which are present in the human body in very small quantities lower than that of iron. In dialysis and predialysis patients, zinc, manganese, and selenium are the three major elements that are significantly depleted as compared to normal subjects; these deficiencies are sometimes symptomatic. Zinc deficiency is manifest as anemia, taste abnormality, and delayed wound healing, while selenium deficiency is associated with impaired cardiac function and immunocompromised condition. Zinc has multiple functions, since various enzymes, including DNA polymerase and RNA polymerase, need zinc as a cofactor, while selenium is a component of selenoproteins, including glutathione peroxidase and thioredoxin reductases, which are major antioxidative stress enzymes. These elements can only be supplemented exogenously and contribute to the sustainable QOL of dialysis patients. On the other hand, as regards other trace elements, including copper, chromium, manganese, lead, arsenic, etc., the association of their deficiency or intoxication with various involvements of dialysis patients were investigated, although all investigations were performed in cross-sectional studies or observational studies. Therefore, the supplementation of these elements is inconclusive, given the scarcity of other intervention studies. More conclusive studies are endorsed for the establishment of proper supplementation strategies.

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A meta-analysis of randomized controlled trials

Abstract: Supplemental Digital Content is available in the text

Cited by 21 publications

References 31 publications

Nutrition in Sepsis: A Bench-to-Bedside Review

Nutrition in Sepsis: A Bench-to-Bedside Review

Can selenium‐enriched spirulina supplementation ameliorate sepsis outcomes in selenium‐deficient animals?

Trace Elements and Their Management in Dialysis Patients—Pathophysiology and Clinical Manifestations

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