Category: Trauma

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IV Selenium Supplementation for Critically Ill Patients

Critically ill patient
Increased generation of harmful free radicals and increased systemic inflammation seem to play a direct role in cell death, increased morbidity, and higher mortality in critically ill patients. Selenium is a trace element that has cell regulatory, immunologic, and antioxidant and anti-inflammatory functions. Early selenium supplementation is a promising adjunctive therapy for critically ill patients.

Selenium supplementation – especially intravenous selenium supplementation – seems to be a promising adjuvant treatment for critically ill patients.

The aggregated results of a meta-analysis of the clinical outcomes of selenium supplementation on critically ill patients shows that intravenous selenium supplements as a single therapy can decrease the total mortality and can shorten the length of stay in hospital [Zhao 2019].

Furthermore, the results from the meta-analysis showed that the selenium supplementation did not increase the incidence of drug-induced side effects compared with the control group [Zhao 2019].

Selenium Supplementation for Critically Ill Patients – The Evidence

The researchers reviewed 19 randomized controlled trials enrolling 3341 critically ill patients. There were 1694 critically ill patients in the selenium supplementation group and 1647 critically ill patients in the control group. read more

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Selenium Status and Major Trauma Patients

Abnormally low selenium status is characteristic of critical illness and major trauma. The fall in selenium status occurs very rapidly after major trauma and is associated with poor survival odds. For it to be effective, adjuvant treatment with selenium must be initiated as soon as possible.

Serum selenium and selenoprotein P concentrations drop to very low levels very quickly following major traumatic injury. The very low selenium and selenoprotein P levels are associated with poor survival odds [Braunstein].

These findings in a study done at the University Hospital in Munich, Germany, suggest that selenium supplementation may be a meaningful adjuvant treatment strategy for patients who have suffered major trauma [Braunstein].

Selenium and Critical Illness

Lower than normal selenium status is characteristic of critical illness. Low selenium status can affect the course and the outcome of various diseases [Braunstein].

For example, Bomer et al [2019] found that heart failure patients with serum selenium levels below 70 micrograms per liter had poorer quality of life, poorer exercise capacity, and poorer prognosis than heart failure patients with higher serum selenium levels. read more