Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients

Abstract

In severely ill ICU patients with SIRS, we observed an early 40% decrease in plasma selenium concentrations, reaching values observed in deleterious nutritional selenium deficiency. This prolonged decrease in selenium concentrations could explain the three-fold increase in morbidity and mortality rates in these patients compared with other ICU patients. The efficacy of selenium treatment in SIRS patients with a high gravity index score or hypoperfusion needs further investigation.

Parenteral Selenium Supplementation in Extremely Low Birth Weight Infants: Inadequate Dosage But No Correlation With Hypothyroidism

“…29,30 Selenium has been linked to abnormal thyroid hormone metabolism by animal studies, 31,32 by epidemiological data, 1,2,7 and by clinical studies in humans. 4,33 Selenium deficiency has also been linked to euthyroid sick syndrome, 33 which might have a similar etiology to the transient hypothyroidism frequently seen in extremely premature infants. 34 Darlow et al 20 failed to show any correlation between selenium and T3, T4, or TSH.…”

“…Selenium deficiency has been linked to a multitude of conditions such as Kashin cardiomyopathy, Kashin-Beck osteoartropathy, systemic immune response syndrome and sepsis in adults, and chronic lung disease and hemolytic anemia in preterm infants. [1][2][3][4][5][6][7] Selenium as selenocysteine is a component of the metalloenzymes that are present in many body tissues, including glutathione peroxidase (GSHPx) and iodothyronine deiodinase type I. [7][8][9] GSHPx serves as an antioxidant, which protects cells from free radical damage.…”

Selenium in Biology: Facts and Medical Perspectives

“…Low serum selenium levels correlate with the low GPx activity and are almost consistently found during the hyperdynamic septic phase of shock, after surgery, or in patients with liver diseases (Robinson et al, 1992). Also, serum selenium levels correlate inversely with mortality (Forceville et al, 1998). The reason is still not clear.…”

“…Selenium-deficient nutrition is discussed as a predisposing factor for SIRS (Richard et al, 1991;Ringstad et al, 1993). But also a rapid redistribution of selenium in the body or an excretion through the kidney at the beginning of the disease has been supposed, but could not yet be analytically verified (Forceville et al, 1998). During longer parenteral nutrition and continuation of the disease the selenium level further decreases (Hawker et al, 1990;Sando et al, 1992).…”

Trace Elements in Critical Illness

“…Serum selenium level and enzyme assay for GSH-Px are used as monitoring indices in the intensive care unit. Like other trace elements, plasma selenium levels are decreased during critical illness [27]. Selenium deficiency occurs in patients with bowel resection, gastro-intestinal fistulas, alcoholism, chylous leaks, HIV infection, and those undergoing venovenous hemodialysis.…”