Selenium in Cardiac Surgery

Wendt, Sebastian; Schomburg, Lutz; Manzanares, William; Stoppe, Christian

doi:10.1002/ncp.10326

Cited by 15 publications

(5 citation statements)

References 90 publications

(118 reference statements)

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“…In 2019, anesthesiologists in Germany published a review study discussing the effects of low levels of preoperative Se level on patient's outcomes following the surgery. Unlike the result of the present study, they revealed that low levels of Se may cause chronic cardiovascular disease and also lead to organ dysfunction, such as kidney dysfunction in patients following the cardiac surgery (24).…”

Section: Discussioncontrasting

confidence: 99%

Evaluation the preventive effect of Selenium on acute kidney injury following on-pump cardiac surgery

Zeraati

Amini

Samadi

et al. 2021

ircmj

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Introduction: patients who undergo on-pump cardiac surgery are at risk of acute kidney injury following the operation. This is mainly due to some ischemic events and also pre- and postoperative stress responses which can result in postoperative organ dysfunction. Selenium as an antioxidant may help to reduce the inflammation and subsequent related complications. In this study we tested that if administration of oral Se compliment before and following the on-pump cardiac surgery can reduce the incidence or severity of kidney injury following the operation. Methods: In a randomized double-blind trial we divided the randomly selected patients who were candidate for on-pupm cardiac surgery into two groups of those who received selenium and control group. In selenium group we administrated 500 µg of selenium orally 14 and 2 hours before surgery and every 12 hours postoperatively for 2 days (overall 3000 µg) while the control group received only the routine and standard care. Subsequently patients were closely observed for serum creatinine rise and incidence of post-operative AKI during their hospitalization period in both groups using both Rifle and AKIN criteria separately. Besides, some additional data including: ICU-stay, duration of the operation and need for Blood products during the operation were recorded. At the end, the statistical analysis was carried out using SPSS 11.5 software in order to determine any significant difference in case and control group. Results: The study population included 120 patients divided in two equal groups of 60, consisting of 46 (38.3%) males and 74 (61.7%) females with the mean age of 52.8±16.7 years. Both groups were similar regarding the demographics and comorbidities. Also statistics showed no significant difference regarding Cardiac Operative Risk Evaluation (EuroSCORE) in both groups. Considering the RIFLR criteria, AKI occurred in 11 (17.9%) patients in selenium group and 13 (21.4%) patients in control group while based on AKIN criteria figures were 17 (28.6%) and 21 (35.7%) in selenium and the control group , respectively. The most frequent stage of AKI among patients was the first stage in both group and the highest rate of AKI occurred in 3-4 days after surgery in both groups. Conclusion: According to our research Administrating oral Selenium was not beneficial in order to prevent AKI after on-pump cardiac surgery.

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Section: Discussioncontrasting

confidence: 99%

Evaluation the preventive effect of Selenium on acute kidney injury following on-pump cardiac surgery

Zeraati

Amini

Samadi

et al. 2021

ircmj

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“…A recent report identified the protein in urine as a novel and early biomarker of acute kidney injury [29] and we described increased SELENBP1 concentrations in patients with acute coronary syndrome at high risk of major cardiac events [30]. Cardiac surgery negatively affects Se status and Se deficiency increases the risk of ischaemic heart disease [31] and promotes organ dysfunction after cardiac surgery [32]. To better characterize circulating SELENBP1 as a biomarker of myocardial stress, we monitored its concentration in patients undergoing surgery with cardioplegia-induced myocardial arrest and the use of a cardio-pulmonary bypass (CPB) and evaluated its potential diagnostic value with respect to convalescence and survival.…”

Section: Introductionmentioning

confidence: 99%

Selenium-Binding Protein 1 Indicates Myocardial Stress and Risk for Adverse Outcome in Cardiac Surgery

et al. 2019

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Selenium-binding protein 1 (SELENBP1) is an intracellular protein that has been detected in the circulation in response to myocardial infarction. Hypoxia and cardiac surgery affect selenoprotein expression and selenium (Se) status. For this reason, we decided to analyze circulating SELENBP1 concentrations in patients (n = 75) necessitating cardioplegia and a cardiopulmonary bypass (CPB) during the course of the cardiac surgery. Serum samples were collected at seven time-points spanning the full surgical process. SELENBP1 was quantified by a highly sensitive newly developed immunological assay. Serum concentrations of SELENBP1 increased markedly during the intervention and showed a positive association with the duration of ischemia (ρ = 0.6, p < 0.0001). Elevated serum SELENBP1 concentrations at 1 h after arrival at the intensive care unit (post-surgery) were predictive to identify patients at risk of adverse outcome (death, bradycardia or cerebral ischemia, “endpoint 1”; OR 29.9, CI 3.3–268.8, p = 0.00027). Circulating SELENBP1 during intervention (2 min after reperfusion or 15 min after weaning from the CPB) correlated positively with an established marker of myocardial infarction (CK-MB) measured after the intervention (each with ρ = 0.5, p < 0.0001). We concluded that serum concentrations of SELENBP1 were strongly associated with cardiac arrest and the duration of myocardial ischemia already early during surgery, thereby constituting a novel and promising quantitative marker for myocardial hypoxia, with a high potential to improve diagnostics and prediction in combination with the established clinical parameters.

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“…It has been established that selenium, a component of several antioxidant enzymes, is essential during oxidative stress due to its antioxidant and anti-inflammatory properties [ 14 ]. Diminished selenium levels have been independently associated with the development and aggravation of organ dysfunction, systemic inflammatory response, ischemic reperfusion injury, and higher mortality after cardiac surgery [ 15 , 16 ]. Studies have shown that selenium is not only protective against perioperative oxidative tissue damage but can also suppress IRI-induced leukocytosis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of selenium on patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials

Sarhan,

Awad,

Alassiri

et al. 2024

J Cardiothorac Surg

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Introduction Postoperative complications pose significant challenges in cardiac surgery and with the evolution of selenium as a potential anti-inflammatory agent, some studies reported its inefficiency. Thus, we conducted our meta-analysis to evaluate the impact of selenium supplementation on cardiac surgery patients. Methods Different databases such as PubMed, Embase, and Cochrane Library from inception till January 2024 were searched identifying a total of seven randomized-controlled trials involving selenium supplementation after cardiac surgery. Risk ratio (RR) and Mean difference (MD) were calculated with a 95% confidence interval (CI). Results The selenium intervention significantly raised the incidence of Acute Kidney injury (RR 0.76; 95% CI: 0.59, 0.98; P = 0.04) while significantly reducing the duration of hospital stay (MD -1.33; 95% CI: -2.51, -0.16; P = 0.03) and postoperative CRP levels (SMD -0.18; 95% CI: -0.34, -0.02; P = 0.03). The effect of selenium intervention on days spent in ICU (MD -0.01; 95% CI: -0.28, 0.25; P = 0.92), mortality (RR 1.07; 95% CI: 0.84, 1.37; P = 0.57) and incidence of hospital acquired infections (RR 0.98; 95% CI: 0.76, 1.26; P = 0.88) is insignificant. Conclusion Selenium supplementation did not significantly reduce major postoperative complications in cardiac surgery patients. However, its ability to modulate inflammation, as reflected in decreased C-reactive protein levels, highlights its potential role in managing the inflammatory response. Future investigations should focus on optimized selenium supplementation strategies in conjunction with other antioxidants to enhance its benefits.

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Selenium in Cardiac Surgery

Cited by 15 publications

References 90 publications

Evaluation the preventive effect of Selenium on acute kidney injury following on-pump cardiac surgery

Evaluation the preventive effect of Selenium on acute kidney injury following on-pump cardiac surgery

Selenium-Binding Protein 1 Indicates Myocardial Stress and Risk for Adverse Outcome in Cardiac Surgery

Efficacy of selenium on patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials

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