A meta-analysis of randomized controlled trials Efficacy of selenium treatment for sepsis
A meta-analysis of randomized controlled trials Efficacy of selenium treatment for sepsis
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DOI：
10.1097/md.0000000000014733
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发表时间：
2019-03-01
期刊：
影响因子：
1.6
通讯作者：
Tan, Liping
中科院分区：
文献类型：
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作者：
Li, Shaojun;Tang, Tian;Tan, Liping
背景资料：为了了解硒治疗脓毒症综合征患者的临床结局，我们对随机对照试验（RCT）进行了荟萃分析。方法：系统回顾了13项比较硒和安慰剂治疗脓毒症患者的RCT。结果：然而，在这方面，我们无法检测到硒治疗与不同时间过程中死亡率降低的相关性，（相对风险[RR] [95%置信区间，CI]：第28天0.94 [0.82-1.06];第90天0.73 [0.36-1.47]; 6个月1.16 [0.78-1.71]）。补充硒在肾衰竭发生率、继发感染或机械通气持续时间方面未显示出有利的疗效（RR [95% CI]：0.65 [0.41-1.03]; 0.96 [0.87-1.06];标准平均差[SMD] [95% CI]：0.17 [-0.30-0.63];分别）。有趣的是，我们发现硒治疗对脓毒症患者有益，可减少血管加压治疗的持续时间，在重症监护室和医院的停留时间，以及呼吸机相关性肺炎的发生率（SMD [95% CI]：-0.75 [-1.37 to -0.13]; -0.15 [CI：-0.25 to -0.04]; -1.22 [-2.44 to -0.01]; RR [95% CI]：0.61 [0.42-0.89];分别）。根据我们的研究结果，不能建议常规使用静脉补硒。
Background: To understand the clinical outcomes of selenium therapy in patients with sepsis syndrome, we conducted a metaanalysis of randomized controlled trials (RCT).Methods: A total of 13 RCTs comparing selenium and placebo for patients with sepsis were reviewed systematically.Results: However, we could not detect the association of selenium treatment with a decreased mortality at different time course (relative risk [RR] [95% confidence interval, CI]: 0.94 [0.82-1.06] at day 28; 0.73 [0.36-1.47] at day 90; 1.16 [0.78-1.71] at 6 months; respectively). Selenium supplementation did not show favorable efficacy in the incidence of renal failure, secondary infection or duration of mechanical ventilation (RR [95% CI]: 0.65 [0.41-1.03]; 0.96 [0.87-1.06]; standard mean difference [SMD] [95% CI]: 0.17 [-0.30-0.63]; respectively). Interestingly, we found that selenium therapy was benefit for sepsis patients with reduced duration of vasopressor therapy, staying time in intensive care unit and hospital, and incidence of ventilator-associated pneumonia (SMD [95% CI]: -0.75 [-1.37 to -0.13]; -0.15 [CI: -0.25 to -0.04]; -1.22 [-2.44 to -0.01]; RR [95% CI]: 0.61 [0.42-0.89]; respectively).Conclusion: Based on our findings, intravenous selenium supplementation could not be suggested for routine use.