Abstract
The efficacy of selenium administration to treat severe sepsis or septic shock remains controversial. We conduct a systematic review and meta-analysis to explore the impact of selenium administration on severe sepsis or septic shock. We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through May 2020 for randomized controlled trials (RCTs) assessing the effect of selenium administration on severe sepsis or septic shock. Meta-analysis is performed using the random-effect model. Five RCTs involving 1482 patients are included in the meta-analysis. Overall, compared with control group in septic patients, selenium administration is not associated with reduced 28-day mortality (RR=0.93; 95% CI=0.73 to 1.19; P=0.58), but results in substantially decreased all-cause mortality (RR=0.78; 95% CI=0.63 to 0.98; P=0.03) and length of hospital stay (MD=-3.09; 95% CI=-5.68 to -0.50; P=0.02). Selenium administration results in notable decrease in all-cause mortality and length of hospital stay, but shows no substantial influence on the 28-day mortality, length of ICU stay, duration of vasopressor therapy, the incidence of acute renal failure, adverse events, and serious adverse events for septic patients.
Highlights
The efficacy of selenium administration to treat severe sepsis or septic shock remains controversial
Overall, compared with control group in septic patients, selenium administration is not associated with reduced 28-day mortality (RR=0.93; 95% confidence interval (CI)=0.73 to 1.19; P=0.58), but results in substantially decreased all-cause mortality (RR=0.78; 95% CI=0.63 to 0.98; P=0.03) and length of hospital stay (MD=-3.09; 95% CI=-5.68 to -0.50; P=0.02)
Our meta-analysis suggests that selenium administration is associated with significantly reduced all-cause mortality and length of hospital stay, but has no remarkable influence on 28-day mortality, length of intensive care unit (ICU) stay, duration of vasopressor therapy, and the incidence of acute renal failure in septic patients
Summary
The efficacy of selenium administration to treat severe sepsis or septic shock remains controversial. Overall, compared with control group in septic patients, selenium administration is not associated with reduced 28-day mortality (RR=0.93; 95% CI=0.73 to 1.19; P=0.58), but results in substantially decreased all-cause mortality (RR=0.78; 95% CI=0.63 to 0.98; P=0.03) and length of hospital stay (MD=-3.09; 95% CI=-5.68 to -0.50; P=0.02). The impact of selenium administration on severe sepsis or septic shock: a meta-analysis of randomized controlled trials. A cocktail of antioxidants and vitamins containing 800 ug of selenium do not decrease 28-day mortality in patients receiving mechanical ventilation[17]. This increase in the concentration of selenium is associated with the reduction in the oxidative stress and sequential organ failure assessment (SOFA) score[15]
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