A meta-analysis of randomized controlled trials: Efficacy of selenium treatment for sepsis

Medicine (Baltimore). 2019 Mar;98(9):e14733. doi: 10.1097/MD.0000000000014733.

Abstract

Background: To understand the clinical outcomes of selenium therapy in patients with sepsis syndrome, we conducted a meta-analysis of randomized controlled trials (RCT).

Methods: A total of 13 RCTs comparing selenium and placebo for patients with sepsis were reviewed systematically.

Results: However, we could not detect the association of selenium treatment with a decreased mortality at different time course (relative risk [RR] [95% confidence interval, CI]: 0.94 [0.82-1.06] at day 28; 0.73 [0.36-1.47] at day 90; 1.16 [0.78-1.71] at 6 months; respectively). Selenium supplementation did not show favorable efficacy in the incidence of renal failure, secondary infection or duration of mechanical ventilation (RR [95% CI]: 0.65 [0.41-1.03]; 0.96 [0.87-1.06]; standard mean difference [SMD] [95% CI]: 0.17 [-0.30-0.63]; respectively). Interestingly, we found that selenium therapy was benefit for sepsis patients with reduced duration of vasopressor therapy, staying time in intensive care unit and hospital, and incidence of ventilator-associated pneumonia (SMD [95% CI]: -0.75 [-1.37 to -0.13]; -0.15 [CI: -0.25 to -0.04]; -1.22 [-2.44 to -0.01]; RR [95% CI]: 0.61 [0.42-0.89]; respectively).

Conclusion: Based on our findings, intravenous selenium supplementation could not be suggested for routine use.

Publication types

  • Meta-Analysis
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intensive Care Units / statistics & numerical data*
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Pneumonia, Ventilator-Associated / epidemiology
  • Randomized Controlled Trials as Topic
  • Renal Insufficiency / etiology
  • Respiration, Artificial / statistics & numerical data
  • Selenium / therapeutic use*
  • Sepsis / complications
  • Sepsis / drug therapy*
  • Sepsis / mortality
  • Time Factors
  • Young Adult

Substances

  • Selenium