Nicolás MAL, Delarriva AL, Fierro J, Baeza G, Vargas JM, Cornú M, Gimarayz M, Aragües M, Sepúlveda M, González OB, Núñez A, Varezco A

Language: Spanish
References: 21
Page: 211-219
PDF size: 398.80 Kb.

ABSTRACT

Rationale: Selenium is an important part of the antioxidant defense systems of the body. Diminished values of serum selenium might be associated with an increased morbimortality. Objective: To determine the prevalence of hyposelenemia among patients assisted at the Critical Care Polyvalent Unit, and to assess the influence of this condition upon evolution of patient and unit´s length of stay. Material and method: Serum concentration of selenium was measured by means of mass spectrometry in samples of sera retrieved from 58 patients (Males: 48.2%; Ages › 60 years: 38.9%; APACHE II score ≥ 14: 46.3%). Hyposelenemia was established with serum selenium ‹ 80 µg.dL^-1. Nature and strength of association between hyposelenemia and selected demographic, clinical and sanitary predictors were estimated. Results: Hyposelenemia was present in 55.6% of the study serie. Hyposelenemia was independent from proposed predictors. However, hyposelenemia prevailed in patients with high APACHE II scores, multiple organ dysfunction, and infections; and those who died during their admission to the unit. Conclusions: Hyposelenemia was prevalent among critically ill patients. Further studies should be conducted to assess the impact of selenium supplementation therapies upon the examined predictors.

REFERENCES

1. Heyland DK, Dhaliwal R, Suchner U, Berger MM. Antioxidant nutrients: A systematic review of trace elements and vitamins in the critically ill patient. Intensive Care Med 2005;31:327-37.

2. Manzanares W, Dhaliwal R, Jiang X, Murch L, Heyland DK. Antioxidant micronutrients in the critically ill: A systematic review and meta-analysis. Crit Care 2012;16:R66.

3. Hayes GL, McKinzie BP, Bullington WM, Cooper TB, Pich NA. Nutritional supplements in critical illness. AACN Adv Crit Care 2011;22:301-16.

4. Sriram K, Lonchyna VA. Micronutrient supplementation in adult nutrition therapy: Practical considerations. JPEN J Parenter Enteral Nutr 2009;33:548-62. 5. Rech M, To L, Tovbin A, Smoot T, Mlynarek M. Heavy metal in the intensive care unit: A review of current literature on trace element supplementation in critically ill patients. Nutr Clin Pract 2014;29:78-89. 6. Manzanares W, Langlois PL, Hardy G. Update on antioxidant micronutrients in the critically ill. Curr Opin Clin Nutr Metab Care 2013;16:719-25. 7. Berger MM, Soguel L, Shenkin A, Revelly JP, Pinget C, Baines M, et al. Influence of early antioxidant supplements on clinical evolution and organ function in critically ill cardiac surgery, major trauma, and subarachnoid hemorrhage patients. Crit Care 2008; 12:R101.

5. Berger MM, Binnert C, Chiolero RL, Taylor W, Raffoul W, Cayeux MC, et al. Trace element supplementation after major burns increases burned skin trace element concentrations and modulates local protein metabolism but not whole-body substrate metabolism. Am J Clin Nutr 2007;85:1301-6.

6. Vincent JL, Forceville X. Critically elucidating the role of selenium. Curr Opin Anaesthesiol 2008;21:148-54.

7. Forceville X, Vitoux D, Gauzit R, Combes A, Lahilaire P, Chappuis P. Selenium, systemic immune response syndrome, sepsis, and outcome in critically ill patients. Crit Care Med 1998;26:1536-44.

8. Manzanares W, Biestro A, Galusso F, Torre MH, Mañay N, Pittini G, et al. Serum selenium and glutathione peroxidase-3 activity: Biomarkers of systemic inflammation in the critically ill? Intensive Care Med 2009;35:882-9.

9. Steinbrenner H, Sies H. Protection against reactive oxygen species by selenoproteins. Biochim Biophys Acta 2009;1790:1478-85.

10. Fairweather-Tait SJ, Collings R, Hurst R. Selenium bioavailability: Current knowledge and future research requirements. Am J Clin Nutr 2010; 91:1484S-1491S.

11. Lu J, Holmgren A. Selenoproteins. J Biol Chem 2009;284:723-7.

12. Bellinger FP, Raman AV, Reeves MA, Berry M. Regulation and function of selenoproteins in human disease. Biochem J 2009;422:11-22.

13. Sieniawska CE, Meniskov R, Delves HT. Determination of total selenium in serum, whole blood and erythrocytes by ICP-MS. J Anal Atom Spectr 1999; 14:109-12.

14. Longnecker MP, Stram DO, Taylor PR, Levander OA, Howe M, Veillon C, et al. Use of selenium concentration in whole blood, serum, toenails, or urine as a surrogate measure of selenium intake. Epidemiology 1996;384-90.

15. Santana Porbén S, Martínez Canalejo H. Manual de Procedimientos Bioestadísticos. Segunda Edición. EAE Editorial Académica Española. ISBN-13: 9783659059629. ISBN-10: 3659059625. Madrid: 2012.

16. Santana Porbén S, Martínez Canalejo H. Manual de Estadísticas no Paramétricas. Editorial PUBLICIA. ISBN: 978-3-639-55468-7. Saarbrücken: 2013.

17. Gramm HJ, Kopf A, Brätter P. Nutrition physiologic significance of the trace element selenium within the scope of parenteral nutrition therapy. Med Klin [Munich] 1995;90(Suppl 1):10-5.

18. Hardy G, Hardy I, Manzanares W. Selenium supplementation in the critically ill. Nutr Clin Pract 2012;27: 21-33.

19. Manzanares W, Hardy G. Selenium supplementation in the critically ill: Posology and pharmacokinetics. Curr Opin Clin Nutr Metab Care 2009; 12:273-80.

20. Manzanares W, Biestro A, Torre MH, Galusso F, Facchin G, Hardy G. High-dose selenium reduces ventilator-associated pneumonia and illness severity in critically ill patients with systemic inflammation. Intensive Care Med 2011;37:1120-7.

21. Angstwurm MW, Engelmann L, Zimmermann T, Lehmann C, Spes CH, Abel P, et al. Selenium in Intensive Care (SIC): Results of a prospective randomized, placebo-controlled, multiple-center study in patients with severe systemic inflammatory response syndrome, sepsis, and septic shock. Crit Care Med 2007;35:118-26.