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KMID : 0390320180280010017
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Chungbuk Medical Journal
2018 Volume.28 No. 1 p.17 ~ p.25
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Is Selenium Replacement Necessary for Critically Ill Patients?
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Shin Yoon-Mi
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Abstract
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Nutritional support is important treatment aspect in critically ill patients, considering their underlying
disease and disease severity, and it wholey depends on their physician’s decision and order. There are many total parenteral nutritional fluids and enteral feeding materials, but it is not well known about administration of vitamins and antioxidants. Selenium depletion has been reported in critical illness with systemic inflammatory response syndrome that correlates with an increased mortality and morbidity. Many studies have shown that the supplementation of selenium either as monotherapy or in an antioxidant micronutrient combination was able to reduce illness severity, improve clinical outcome, reduce infectious complications, and decrease mortality. However several studies and recent meta-analysis showed it is not effective in critically ill patients. In this journal, I reviewed past studies about the selenium replacement and prognosis of critically ill patients in intensive care unit and considered that it is very difficult to prove improvement of clinical prognosis in severe critically ill patients with sepsis or septic shock, only by nutritional support. Therefore, I suggest the high dose selenium administration of above 500 μg/day for more than 5 days selectively to the patient with low albumin level or malnutrition when his clnical course is aggravating to the sepsis or septic shock.
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KEYWORD
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Selenium, Crtically ill patient, Sepsis, Mortality
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