Effects of High-Dose Selenium on Mortality of Sepsis and Septic Shock Patients with Severe Selenium Deficiency in Taiwan

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Published Feb 27, 2024
DOI: https://doi.org/10.18103/mra.v12i2.5044

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Main Article Content

Chun-Man Chen
TaiRx, Inc., Taipei 115602, Taiwan
Yen-Ling Chen
TaiRx, Inc., Taipei 115602, Taiwan
Shu-Min Lin
Department of Thoracic Medicine, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan; Department of Respiratory Therapy, Chang Gung Memorial Hospital, Taoyuan 333423, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu 300044, Taiwan
Huang-Pin Wu
Division of Pulmonary, Critical Care and Sleep Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204201, Taiwan
Jiun-Nong Lin
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 840203, Taiwan; Department of Critical Care Medicine, E-Da Hospital, I-Shou University, Kaohsiung 824005, Taiwan
Kai-Huang Lin
Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 500209, Taiwan
Chin-Ming Chen
Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan 710402, Taiwan; School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung 804201, Taiwan
Kuang-Yao Yang
Department of Chest Medicine, Taipei Veterans General Hospital, Taipei 112201, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112304, Taiwan
Shih-Chi Ku
Division of Chest Medicine, Department of Internal Medicine, National Taiwan University Hospital, Taipei 100225, Taiwan
Fu-Tsai Chung
Department of Thoracic Medicine, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan; Department of Thoracic Medicine, New Taipei Municipal TuCheng Hospital, New Taipei City 236043, Taiwan; Department of Respiratory Therapy, New Taipei Municipal TuCheng Hospital, New Taipei City 236043, Taiwan; School of Medicine, College of Medicine, Chang Gung University, Taoyuan City 333423, Taiwan
Chih-His Kuo
Department of Thoracic Medicine, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan
Chien Tung Chiu
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 840203, Taiwan
Chi-Kuei Hsu
School of Medicine, College of Medicine, I-Shou University, Kaohsiung 840203, Taiwan
Hsin-Hui Hsu
Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 500209, Taiwan
Chien-Ming Chu
Division of Pulmonary, Critical Care and Sleep Medicine, Keelung Chang Gung Memorial Hospital, Keelung 204201, Taiwan
Han-Chung Hu
Department of Thoracic Medicine, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan
Chung-Shu Lee
Department of Thoracic Medicine, Chang Gung Memorial Hospital, School of Medicine, Chang Gung University, Taoyuan 333423, Taiwan; Department of Pulmonary and Critical Care Medicine, New Taipei Municipal Tucheng Hospital, New Taipei City 236043, Taiwan
Shin-Hwar Wu
Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 500209, Taiwan
I-Chieh Mao
Division of Critical Care Internal Medicine, Department of Emergency Medicine and Critical Care, Changhua Christian Hospital, Changhua 500209, Taiwan
Ting-Yu Chao
TaiRx, Inc., Taipei 115602, Taiwan
Yi-Wen Chu
TaiRx, Inc., Taipei 115602, Taiwan
Du-Shieng Chien
TaiRx, Inc., Taipei 115602, Taiwan

Abstract

The relationship between serum selenium levels and mortality was investigated in septic patients with severe selenium deficiency (baseline selenium ≤ 80 ng/mL). Eligible patients of sepsis or septic shock were randomized to receive Placebo or High-Dose Selenium (1,000 μg/day) via intravenous injection. Safety, serum selenium, mortality, SOFA, and Glasgow Coma Scale (GCS) scores were monitored. Among all 330 subjects, 27.9% subjects (n=92) had severe selenium deficiency (mean serum selenium = 66.5 ng/mL). Mortality of severe selenium deficiency patients was 27.2%, significantly higher than 17.9% of all subjects. In severe selenium deficiency Placebo group (n=45), 62% subjects showed gradual increase of selenium levels to ~110 ng/mL (mortality ~21.4%), while 38% subjects remained at low selenium ≤ 110 ng/mL throughout study (mortality ~41.2%). Mortality for Placebo subjects with normal baseline selenium ≥ 110 ng/mL was 13.6%. With High-Dose Selenium treatment, 91% of severe selenium deficiency subjects showed quick selenium increase to ~110 ng/mL (mortality 25.5%). Mortality was reduced to 8.6% for High-Dose Selenium subjects with baseline selenium ≥ 110 ng/mL. The odds ratio showed significantly greater survival of High-Dose Selenium subjects with baseline selenium ≥ 110 ng/mL (91.4%) than severe selenium deficiency Placebo subjects (74.1%). Mean baseline SOFA scores for severe selenium deficiency patients were 9.1–9.4, decrease of SOFA scores in High-Dose Selenium subjects was significantly greater than Placebo subjects, along with significant improvement of GCS scores. Repeated infusion of High-Dose Selenium in severe selenium deficiency patients for 14 days was safe and well-tolerated. Mortality for patients with sepsis was clearly affected by serum selenium concentrations. High mortality (41–50%) was observed in the sepsis patients constantly with low selenium £ 80 ng/mL; mortality was reduced to 21–23% if their serum selenium could be increased to ≥ 110 ng/mL. High-Dose Selenium resulted in rapid restoration of serum selenium and improved the survival of severe selenium deficiency septic patients. Low mortality (9–14%) was observed in the sepsis patients starting with baseline selenium ≥ 110 ng/mL. Overall this study demonstrates the significant impact of insufficient selenium levels on the mortality of septic patients. Treatment with high-dose selenium reduced the mortality of severe selenium deficiency septic subjects.

Keywords: Selenium deficiency, sepsis and septic shock, mortality, SOFA score, Asian

Article Details

How to Cite
CHEN, Chun-Man et al. Effects of High-Dose Selenium on Mortality of Sepsis and Septic Shock Patients with Severe Selenium Deficiency in Taiwan. Medical Research Archives, [S.l.], v. 12, n. 2, feb. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5044>. Date accessed: 21 dec. 2024. doi: https://doi.org/10.18103/mra.v12i2.5044.
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Issue
Vol 12 No 2 (2024): February issue, Vol.12, Issue 2
Section
Research Articles

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