Selenium supplementation for critically ill adults.

Study answer

What this study found

There is no clear evidence that selenium or ebselen supplementation reduces mortality in critically ill adults. A pooled 28-day analysis suggested a possible mortality reduction, RR 0.84 (0.69 to 1.02), but the 90-day estimate was RR 0.96 (0.78 to 1.18), and the apparent benefit was largely driven by trials at high risk of bias. There were no clear benefits for infections, days on mechanical ventilation, ICU length of stay, or hospital length of stay. Overall confidence in the evidence was very low.

Study & population

Systematic review and meta-analysis of randomized trials in critically ill adults receiving ICU care.

Intervention

Across the included trials, selenium was usually given as intravenous sodium selenite, with regimens ranging from 500 mcg/day to a 4000 mcg loading dose followed by 300 to 1000 mcg/day for 3 to 28 days.

Key limitation

The evidence base was small and methodologically weak, with many trials at high risk of bias and very low certainty overall.

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Original abstract