The effects of selenium administration on mean platelet volume, neutrophil-to-lymphocyte ratio, and red cell distribution width in critically ill older adults: A double-blinded randomized clinical trial

Abstract

BackgroundLow serum Selenium (Se) levels in critical patients have been associated with poor clinical outcomes and higher mortality rates. The purpose of this study was to investigate the effect of Se administration on mean platelet volume (MPV), neutrophil-to-lymphocyte ratio (N/L), and red cell distribution width (RDW) in older adults admitted to the intensive care unit (ICU). MethodThis study was a double-blinded randomized clinical trial. Critically ill patients were randomly divided into two groups of Se and placebo. The Se group (N=30) initially received 3000 mg of Se at once within 3 hours, followed by a dose of 1500 mg daily for 10 days as a one-hour infusion. The control group (N=30) received normal saline for 10 days. A venous blood sample was collected on the first and 10th day. Statistical analysis was performed using SPSS.26 statistical software. To analyze quantitative data in two groups, based on the estimated normality, an independent t-test was used. P value less than 0.05 was considered statistically significant. ResultsOn day 10, the MPV value in the Se group was significantly lower compared to the placebo group (9.32 ± 1.78 and 10.43 ± 2.06, respectively, p = 0.03). Within the Se group, contrary to the controls, the MPV value decreased significantly from day 1 to day 10 (p<0.001). Further, the RDW value in the Se group was significantly lower compared to the placebo group (13.77 ± 1.57 and 15.32 ± 2.42, respectively, p = 0.005). The N/L ratio remained similar between the two groups before and after the intervention. ConclusionOur findings suggest that Se can affect the MPV and RDW parameters in older adults hospitalized in the ICU. However, further studies with a larger population are necessary to support these findings. Clinical Relevancy StatementThe effects of selenium administration on hematological parameters in older adults admitted to the ICU are not well-established. There is limited direct evidence linking serum selenium levels to erythrocyte and hemoglobin stability in humans. The current clinical trial promotes the current literature and shows that selenium holds potential in management of the older ICU patients.