Selenium supplementation in critically ill patients: a systematic review and meta-analysis

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#antioxidants #critical-illness #dietary-supplements #dose-response-relationship-drug #humans

Selenium supplementation in critically ill patients: a systematic review and meta-analysis

Landucci et al., 2014 | J Crit Care | Meta Analysis

Citation

Landucci Francesco, Mancinelli Paola, ... Virgili Gianni. Selenium supplementation in critically ill patients: a systematic review and meta-analysis. J Crit Care. 2014-Feb;29(1):150-6. doi:10.1016/j.jcrc.2013.08.017

Abstract

PURPOSE: The oxidative stress is recognized as a constant feature in critical illness. Nevertheless, the use of antioxidant therapy remains controversial. We tried to demonstrate that intravenous selenium supplementation could promote antioxidant status and help protect against infection and organ failure, improving outcome in critically ill patients. MATERIALS AND METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing the exogenous supplementation of selenium versus standard therapy without any adjuvant in critically ill adults. RESULTS: Nine RCTs met inclusion criteria. Selenium supplementation was associated with a reduction in 28-day mortality of borderline statistical significance (risk ratio = 0.84, 95% confidence interval 0.71-0.99, P = .04). The analysis of pre-defined subgroups detected no significant effects regarding the supplementation with doses of selenium ≤ 500 μg/d, administration of a load dose with a bolus and duration of treatment. Only 2 studies analyzed 6-month mortality and could not show a difference. No effects could be demonstrated on hospital length of stay, pulmonary infections, or renal failure. CONCLUSIONS: The use of high-dose selenium might be associated with a beneficial effect on 28-day mortality in critically ill patients. Nevertheless, the use of selenium as adjuvant therapy needs further evaluations.

Key Findings

Nine RCTs met inclusion criteria. Selenium supplementation was associated with a reduction in 28-day mortality of borderline statistical significance (risk ratio = 0.84, 95% confidence interval 0.71-0.99, P = .04). The analysis of pre-defined subgroups detected no significant effects regarding the supplementation with doses of selenium ≤ 500 μg/d, administration of a load dose with a bolus and duration of treatment. Only 2 studies analyzed 6-month mortality and could not show a difference. No ef

Outcomes Measured

  • Requires manual extraction

Population

Field Value
Population See abstract
Sample Size 2
Age Range See abstract
Condition stress

MeSH Terms

  • Antioxidants
  • Critical Illness
  • Dietary Supplements
  • Dose-Response Relationship, Drug
  • Humans
  • Oxidative Stress
  • Randomized Controlled Trials as Topic
  • Selenium

Evidence Classification

  • Level: Meta Analysis
  • Publication Types: Journal Article, Meta-Analysis, Systematic Review
  • Vertical: selenium

Provenance

Source extracted via PubMed E-utilities API on 2026-04-09