Selenium supplementation for sepsis: a meta-analysis of randomized controlled trials
Selenium supplementation for sepsis: a meta-analysis of randomized controlled trials
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DOI：
10.1016/j.ajem.2013.04.020
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发表时间：
2013-08-01
影响因子：
3.6
通讯作者：
Xia, Zhaofan
中科院分区：
文献类型：
--
作者：
Kong, Zhengdong;Wang, Fei;Xia, Zhaofan
背景：最近，有几项研究探讨了补充硒对脓毒症患者的影响。但是，没有得出一致的结论。因此，我们的目的是系统地总结现有的随机对照试验（RCTs），以评估补充硒对脓毒症patients.Methods的重要临床结局的影响：Pubmed，Embase和科克伦对照试验的中央注册系统的文献检索进行（截至2012年8月25日）。如果RCT报告了硒补充剂对脓毒症患者治疗的影响，则纳入RCT。采用固定效应模型，在异质性显著的情况下，采用随机效应模型。汇总分析显示，补硒并不能降低全因死亡率（相对风险[RR] = 0.89，95%置信区间[CI]：0.73-1.07，P = .21），医院获得性肺炎（RR = 1.15，95% CI：0.73-1.82，P = 0.55）或重症监护室住院时间（加权平均差异= 2.32天，95% CI：-0.05至4.69; P =. 05）。此外，未观察到组间不良事件的显著差异（RR = 0.97，95%CI：0.72-1.33，P = 0.87）。结论：目前的荟萃分析显示，补充硒对脓毒症患者没有益处。由于纳入的随机对照试验数量有限，未来需要更多关于硒治疗脓毒症患者的前瞻性多中心临床试验。(C)2013 Elsevier Inc. All rights reserved.
Background: Recently, several studies were conducted to investigate the effect of selenium supplementation in septic patients. However, no consistent conclusion was made. Thus, we aimed to systematically summarize the available randomized controlled trials (RCTs) to evaluate the effect of selenium supplementation on important clinical outcomes in septic patients.Methods: A systematic literature search of Pubmed, Embase, and the Cochrane Central Register of Controlled Trials was conducted (up to August 25, 2012). RCTs were included if they reported the effect of selenium supplementation on the treatment of septic patients. A fixed-effect model was used, and in the case of significant heterogeneity, a random-effects model was employed.Results: Five studies with a total of 530 patients were included. Pooled analysis showed that selenium supplementation did not reduce all-cause mortality (relative risk [RR] = 0.89, 95% confidence interval [CI]: 0.73-1.07, P = .21), hospital-acquired pneumonia (RR = 1.15, 95% CI: 0.73-1.82, P = .55), or length of intensive care unit stay (weighted mean differences = 2.32 days, 95% CI: -0.05 to 4.69; P =. 05). In addition, no significant difference was observed regarding adverse events between groups (RR = 0.97, 95% CI: 0.72-1.33, P = .87).Conclusions: The present meta-analysis showed no benefit of selenium supplementation in patients with sepsis. Due to the limited number of RCTs included, more prospective multicenter clinical trials on selenium therapy in septic patients are warranted in the future. (C) 2013 Elsevier Inc. All rights reserved.