Biomarkers in critically ill patients with systemic inflammatory response syndrome or sepsis supplemented with high-dose selenium |
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| Affiliation: | 1. Institute of Clinical Biochemistry, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic;2. Department of Anaesthesiology and Intensive Care, First Faculty of Medicine, Charles University in Prague and General University Hospital in Prague, Czech Republic;3. Department of Internal Medicine, Nutrition and Dietetic Center, Thomayer University Hospital, Prague, Czech Republic;4. Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States;1. Metabolic Medicine Research Unit, Imperial College London, United Kingdom;2. Gastro Surgical Laboratory, University of Gothenburg, Sweden;3. Diabetes Complications Research Center, Conway Institute, University College Dublin, Ireland;1. Discipline of Nutrition and Metabolism, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil;2. Pediatric Nephrology Section, Federal University of São Paulo, São Paulo, Brazil;3. Pediatric Intensive Care Unit, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil;4. Discipline of Allergy and Immunology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil;1. College of Medical Sciences, State University of Campinas (UNICAMP), Campinas, Brazil;2. College of Pharmaceutical Sciences, University of Sao Paulo (USP), São Paulo, Brazil;3. College of Applied Sciences, State University of Campinas (UNICAMP), Campinas, Brazil;1. Trauma Research Center, Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;2. Department of Neurosurgery, Shiraz University of Medical Sciences, Shiraz, Iran;3. Division of Trauma and Emergency Surgery, Department of Surgery, Karolinska University Hospital, Stockholm, Sweden;4. School of Medical Sciences, Örebro University, Örebro, Sweden;5. Unit of Biostatistics, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden;6. Division of Trauma and Emergency Surgery, Department of Surgery, Örebro University Hospital, Örebro, Sweden;7. Shahid Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran;1. Division of Pulmonary, Allergy, and Critical Care, Department of Medicine, Emory University, Atlanta, Georgia, USA;2. Emory Critical Care Center, Emory University, Atlanta, Georgia, USA;3. Division of Endocrinology, Metabolism and Lipids, Department of Medicine, Emory University, Atlanta, Georgia, USA;4. Atlanta VA Medical Center, Decatur, Georgia, USA;5. Division of Neonatal-Perinatal Medicine, Department of Pediatrics, Emory University, Atlanta, Georgia, USA;1. Department of Intensive Care Medicine, HwaMei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang 315000, China;2. Department of Emergency, Ningbo Yinzhou No. 2 Hospital, Ningbo, Zhejiang 315000, China;3. Department of Intensive Care Medicine, Zhejiang Hospital, Hangzhou, Zhejiang 310000, China |
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| Abstract: | ObjectiveLow levels of selenium (Se) and glutathione peroxidase (GSHPx), a key selenoenzyme, were documented in systemic inflammatory response syndrome (SIRS) and sepsis, both associated with high mortality. Se supplementation had mixed effects on outcome. We hypothesized that Se supplementation could have a different impact on biomarkers and 28-day mortality in patients with SIRS vs. sepsis.MethodsAdult patients with SIRS or sepsis were randomized to either high-dose (Se+, n = 75) or standard-dose (Se−, n = 75) Se supplementation. Plasma Se, whole blood GSHPx activity, C-reactive protein (CRP), procalcitonin (PCT), prealbumin, albumin and cholesterol levels were measured serially up to day 14.ResultsThere was no difference in mortality between Se− (24/75) vs. Se+ group (19/75; p = 0.367) or between SIRS and septic patients (8/26 vs. 35/124; p = 0.794). There was a trend to reduced mortality in SIRS patients in the Se+ vs. Se− group (p = 0.084). Plasma Se levels increased in the Se+ group only in patients with sepsis but not in patients with SIRS. Plasma Se levels correlated with GSHPx. In SIRS/Se+ group, Se correlated only with GSHPx. In SIRS/Se− group, Se correlated with cholesterol but not with other biomarkers. In sepsis patients, Se levels correlated with cholesterol, GSHPx and prealbumin. Cholesterol levels were higher in survivors in the Se− group.ConclusionsSe levels correlated with GSHPx activity and other nutritional biomarkers with significant differences between SIRS and sepsis groups. High-dose Se supplementation did not affect mortality but a strong trend to decreased mortality in SIRS patients warrants further studies in this population. |
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| Keywords: | Selenium Systemic inflammatory response syndrome Sepsis Prealbumin Albumin Cholesterol Selenoenzymes Glutathione peroxidase Outcome Mortality |
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