Selenium supplement in critically ill patients: A systematic review

Abstract

Patients hospitalized at the intensive care unit (ICU) are more prone to oxidative stress. Antioxidants such as selenium (Se) may have beneficial effects on outcomes in these patients. Studies and systematic reviews in this field have inconclusive results. Materials and Methods: An updated systematic literature search was done to find clinical trials published in PubMed, Cochrane’s library, ISI web of Science, Scopus, and Ovid databases from the beginning up to April 2020 to assess the effects of daily selenium supplementation on patient’s survival, hospital and ICU stay, duration of mechanical ventilation, infection, acute renal failure (ARF) occurrence and serum creatinine levels. Results: From 1394 gained papers found in the first step of the search, after deleting duplicate findings, 24 studies were included in this meta-analysis. Results of the pooled random-effect size analysis of 24 trials showed no remarkable effect of daily parenteral Se administration on patient’s hospital and ICU stay, duration of mechanical ventilation, infectious complications, ARF, survival and serum creatinine levels (p>0.05). The subgroup analysis showed that daily parenteral Se administration significantly increased the length of ICU stay by 4.48-folds (95%CI: -0.5, 9.46, p=0.07) in doses higher than 1000 µg. Parenteral Se supplementation at the first and following dose of ≤1000 µg reduced the number of ARF at the hospitalized patients by 76% and 45%, respectively (p=0.02, and p=0.05).