Evaluation of the Relationship between Serum Level of Selenium at Arrival to Intensive Care Unit with Duration of Mechanical Ventilation, Mortality and Inflammatory Factors in Multiple Trauma Patients

Document Type : Original Article (s)

Authors

1 Associate Professor, Anesthesiology and Critical Care Research Center, Isfahan university of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan university of Medical Sciences, Isfahan, Iran

Abstract

Background: Selenium is a trace element in the body that plays multiple physiological roles. Lack of this element can affect many serum mediators and immune cells. Abnormality in serum selenium impairs organ function and eventually causes sepsis and organ failure and reduced survival. Therefore this study was conducted to evaluate the relation between serum selenium level at arrival to intensive care unit with duration of ventilation, inflammatory factors and mortality in multiple trauma patients.Methods: 80 multiple trauma patients hospitalized in intensive care unit (ICU) of Al-Zahra hospital, Isfahan, Iran, aged 16 to 85 years were included. Serum level of selenium, C reactive protein (CRP), erythrocyte sedimentation rate (ESR), Interleukin 1(IL1), IL33, and IL6 were measured. Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores were calculated for each patient. Pearson’s correlation was used to analysis the relationship between these variables and serum level of selenium.Findings: All 80 patients were included in final analysis. Mean selenium level was 77.54 ± 44.90 and 43 patient (53.8%) had low levels of selenium and 37patient (46.2%) had normal level. Pearson correlation showed correlation between Serum selenium levels and IL6, ESR, white blood cell (WBC) and mortality, but, there was no significant correlation with other variables.Conclusion: There is no relation between serum level of selenium and mechanical ventilation of multiple trauma patients but there is relation between its level and mortality and some inflammatory factors.

Keywords


  1. Marino PL. The ICU book. 3rd ed. Philadelphia, PA: Lippincott Williams and Wilkins; 2007. p. 1152-3.
  2. Miller RD, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Cohen NH, Young WL. Miller's anesthesia. 8th ed. Philadelphia, PA: Saunders; 2014. p. 286-90.
  3. 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(4): R101.
  4. Motoyama T, Okamoto K, Kukita I, Hamaguchi M, Kinoshita Y, Ogawa H. Possible role of increased oxidant stress in multiple organ failure after systemic inflammatory response syndrome. Crit Care Med 2003; 31(4): 1048-52.
  5. Xu G, Su R, Li B, Lv J, Sun W, Hu B, et al. Trace element concentrations in human tissues of death cases associated with secondary infection and MOF after severe trauma. Biol Trace Elem Res 2015; 168(2): 335-9.
  6. Cander B, Dundar ZD, Gul M, Girisgin S. Prognostic value of serum zinc levels in critically ill patients. J Crit Care 2011; 26(1): 42-6.
  7. Berger MM, Cavadini C, Chiolero R, Dirren H. Copper, selenium, and zinc status and balances after major trauma. J Trauma 1996; 40(1): 103-9.
  8. Park K, Rimm EB, Siscovick DS, Spiegelman D, Manson JE, Morris JS, et al. Toenail selenium and incidence of type 2 diabetes in U.S. men and women. Diabetes Care 2012; 35(7): 1544-51.
  9. 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(7): 1120-7.
  10. Costa NA, Gut AL, Pimentel JA, Cozzolino SM, Azevedo PS, Fernandes AA, et al. Erythrocyte selenium concentration predicts intensive care unit and hospital mortality in patients with septic shock: a prospective observational study. Crit Care 2014; 18(3): R92.
  11. Sakr Y, Reinhart K, Bloos F, Marx G, Russwurm S, Bauer M, et al. Time course and relationship between plasma selenium concentrations, systemic inflammatory response, sepsis, and multiorgan failure. Br J Anaesth 2007; 98(6): 775-84.