Does early administration of selenium improve neurological outcome after cardiac arrest?

• Published in: The American journal of emergency medicine 2009-02, Vol.27 (2), p.176-181
• Main Authors: Reisinger, Johann, MD, Höllinger, Kurt, MD, Lang, Wolfgang, MD, Steiner, Christoph, MD, Winter, Thomas, MD, Winter, Andreas, MD, Mori, Michael, MD, Lindorfer, Alexander, MD, Kiblböck, Daniel, MD, Siostrzonek, Peter, MD
• Format: Article
• Language: English
• Subjects: Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Brain damage; Cardiac arrest; Cardiopulmonary Resuscitation; Central Nervous System Diseases - prevention & control; Chi-Square Distribution; Confidence intervals; Consciousness; CPR; Emergency; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care; Emergency medical care; Female; Free radicals; Heart Arrest - drug therapy; Heart attacks; Humans; Hypotheses; Infusions, Intravenous; Intensive care; Intensive care medicine; Logistic Models; Logistics; Male; Medical sciences; Middle Aged; Regression analysis; Respiratory distress syndrome; Retrospective Studies; Selenium; Selenium - administration & dosage; Selenium - therapeutic use; Trace elements; Treatment Outcome; Unconsciousness
• ISSN: 0735-6757; 1532-8171
• DOI: 10.1016/j.ajem.2008.01.020

Abstract Objective Existing data indicate that selenium supplementation may be beneficial in critically ill patients and in those with ischemic stroke. The purpose of this retrospective study was to explore the influence of early administration of selenium on neurological outcome after cardiopulmonary resuscitation (CPR). Methods We examined 227 consecutive unconscious patients after CPR and excluded 1 individual. The decision to administer selenium was left to the discretion of the attending physician, resulting in 124 patients (55%) who received intravenous selenium (200-1000 μ g/d) for a median of 5 days after CPR. Patients were classified according to the best Glasgow-Pittsburgh cerebral performance categories (CPCs 1-5) achieved within 6 months of follow-up. Results The rate of regaining consciousness (CPC 1-3) after CPR was 58%. Multivariable logistic regression analysis confirmed a shockable first monitored rhythm (adjusted odds ratio, 3.73; 95% confidence interval, 1.85-7.52; P < .001), time to return of spontaneous circulation (adjusted odds ratio, 0.94; 95% confidence interval, 0.91-0.96; P < .001), administration of selenium (adjusted odds ratio, 2.38; 95% confidence interval, 1.19-4.76; P = .014), and the Simplified Acute Physiology Score II (adjusted odds ratio, 0.96; 95% confidence interval, 0.93-0.99; P = .034) as independent predictors of regaining consciousness after CPR. Survival at 6 months of follow-up was not improved significantly by selenium. Conclusion This retrospective analysis leads to the hypothesis that early administration of selenium may improve neurological outcome after cardiac arrest.