Pharmaconutrition with Selenium in ICU Patients

Manzanares, William; Hardy, Ines; Hardy, Gil

doi:10.1007/978-3-642-25716-2_61

Cited by 3 publications

(4 citation statements)

References 46 publications

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“…With respect to the results of the REDOXS study, we wonder how these unexpected results can be explained. Perhaps we could speculate that the absence of an IV bolus of sodium selenite was unable to induce the initial, transient pro‐oxidant and anti‐inflammatory effect of selenite in early phase SIRS and MOD, which is the currently recommended scheme 8 . In addition, according to current knowledge, an IV selenium daily dose of 500 µg is not the recommended parenteral dose when selenium is supplemented as a pharmaconutrient strategy 2 .…”

Section: Pharmaconutrition With Selenium In An Antioxidant Cocktail: mentioning

confidence: 99%

“…Oxidative stress and mitochondrial dysfunction, cellular immune dysfunction, systemic inflammatory response syndrome (SIRS), and multiple‐organ dysfunction (MOD) are key features in the critically ill 7 . As an antioxidant and anti‐inflammatory agent, selenium is an attractive and promising therapeutic strategy in critically ill patients with SIRS/MOD such as patients with sepsis/severe sepsis, trauma, severe pancreatitis, and cardiac surgery 8 . Over the past two decades, several studies showed that plasma selenium levels are decreased in patients with SIRS, although recent findings have been controversial.…”

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confidence: 99%

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Pharmaconutrition With Selenium in Critically Ill Patients

2014

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Selenium is a component of selenoproteins with antioxidant, anti-inflammatory, and immunomodulatory properties. Systemic inflammatory response syndrome (SIRS), multiorgan dysfunction (MOD), and multiorgan failure (MOF) are associated with an early reduction in plasma selenium and glutathione peroxidase activity (GPx), and both parameters correlate inversely with the severity of illness and outcomes. Several randomized clinical trials (RCTs) evaluated selenium therapy as monotherapy or in antioxidant cocktails in intensive care unit (ICU) patient populations, and more recently several meta-analyses suggested benefits with selenium therapy in the most seriously ill patients. However, the largest RCT on pharmaconutrition with glutamine and antioxidants, the REducing Deaths due to Oxidative Stress (REDOXS) Study, was unable to find any improvement in clinical outcomes with antioxidants provided by the enteral and parenteral route and suggested harm in patients with renal dysfunction. Subsequently, the MetaPlus study demonstrated increased mortality in medical patients when provided extra glutamine and selenium enterally. The treatment effect of selenium may be dependent on the dose, the route of administration, and whether administered with other nutrients and the patient population studied. Currently, there are few small studies evaluating the pharmacokinetic profile of intravenous (IV) selenium in SIRS, and therefore more data are necessary, particularly in patients with MOD, including those with renal dysfunction. According to current knowledge, high-dose pentahydrate sodium selenite could be given as an IV bolus injection (1000-2000 µg), which causes transient pro-oxidant, cytotoxic, and anti-inflammatory effects, and then followed by a continuous infusion of 1000-1600 µg/d for up to 10-14 days. Nonetheless, the optimum dose and efficacy still remain controversial and need to be definitively established.

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Section: Pharmaconutrition With Selenium In An Antioxidant Cocktail: mentioning

confidence: 99%

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confidence: 99%

Pharmaconutrition With Selenium in Critically Ill Patients

2014

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“…7 Several clinical trials have examined the roles of some micronutrients as antioxidants in critically ill patients throughout the last 2 decades. 8 It is speculated that supplementation with exogenous antioxidants would be supportive to restore the oxidant/ antioxidant balance in the critically ill. 9 Selenium is an antioxidant that contributes significantly to the proper functioning of all organisms. It is essential in the regulation of selenoproteins, including glutathione peroxidase (GPx), iodothyronine deiodinases, and thioredoxin reductase (TrxR), that are important for the protection against oxidative stress.…”

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confidence: 99%

“…Several clinical trials have examined the roles of some micronutrients as antioxidants in critically ill patients throughout the last 2 decades 8. It is speculated that supplementation with exogenous antioxidants would be supportive to restore the oxidant/antioxidant balance in the critically ill 9. Selenium is an antioxidant that contributes significantly to the proper functioning of all organisms.…”

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confidence: 99%

Antioxidant Effects of Selenium in Adult Critically Ill Patients

Hasani,

Agh,

Irandoost

et al. 2023

Topics in Clinical Nutrition

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Oxidative stress is the fundamental etiology of inflammation and organ failure, and unfavorable consequences characterize critical illness. We searched systematically up to September 2021 to find related randomized controlled trials (RCTs) that investigated the effects of selenium in antioxidant markers of the critically ill. A total of 10 RCTs were included. The results indicated that selenium administration has no significant effects on glutathione peroxidase activity

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