Effects of High-Dose Selenium Supplementation on Oxidative Stress and Inflammatory Markers in Critically Ill Children After Gastrointestinal Surgery: A Randomized Clinical Trial

摘要: Background: Pediatric observational studies have indicated that most critically ill children low serum selenium level, which is associated with the increased incidence of multiple organ failure and deteriorated clinical outcomes. Selenium plays a key role in endogenous antioxidant defense mechanism inflammatory pathways. Objectives: The present study aimed to assess effects high-dose supplementation on improvement oxidative stress indices, as well outcomes, pediatric patients severe inflammation following major gastrointestinal surgeries. Methods: This prospective, single-blind, randomized, parallel group superiority trial was conducted at intensive care unit (PICU) Akbar Hospital Mashhad, Iran 2019. Patients were assigned (high-dose selenium: 20 µg/kg/d) control groups (placebo recommended dietary allowance doses selenium) using stratified blocks. Among 72 eligible after surgery, 66 completed study. Inflammatory markers measured compared between groups, including high-sensitivity C-reactive protein (hsCRP), interleukin 1 beta (IL-1β), prooxidant-antioxidant balance (PAB) assay, Data analysis performed SPSS version intention-to-treat approach. Results: Only 14 had optimal concentrations before surgery PICU admission. At end study, 90.6% (n = 29) intervention 100% 34) those placebo suboptimal levels (< 50 ng/mL). Although decreased post-surgical (-18 mg/mL -37.5 pg/mL for hsCRP IL-1β, respectively), administered dose could not improve glutathione peroxidase (GPx) functional marker, PAB assay single test balance/imbalance oxidants antioxidants simultaneously. Additionally, outcomes such infections, length ICU stay, 28-day mortality did intervention. Conclusions: According results, (20 markers. However, changes no significant GPx concentrations, system,