Abstract
- Background
Selenium plays an indispensable role in biological antioxidant defense through its incorporation into vital selenoproteins, including glutathione peroxidase and thioredoxin reductase. In trauma and critical illness, systemic inflammation and severe oxidative stress frequently deplete body selenium reserves, compromising antioxidant defenses, exacerbating immune dysfunction, and increasing the risks of multi-organ dysfunction syndrome , nosocomial infections, and mortality.
- Methods
This review synthesizes observational and interventional evidence evaluating selenium status, physiological mechanisms, and targeted supplementation strategies in trauma and critically ill populations. Key evaluated endpoints include systemic activity, oxidative stress markers, intensive care unit ICU length of stay, infectious complications, and clinical mortality rates.
- Results
Observational studies consistently show that lower circulating selenium levels correlate with poorer clinical outcomes, including prolonged ICU stays and elevated mortality rates. Supplementation of selenium effectively restores activity, reduces oxidative stress markers, and supports clinical recovery, particularly in patients with baseline selenium deficiency. While overall mortality benefits vary across randomized controlled trials, early and targeted supplementation—especially when combined with synergistic antioxidant micronutrients like vitamins C and E or zinc—enhances systemic antioxidant capacity. Furthermore, clinical benefits depend heavily on baseline status, with severely deficient patients deriving the most pronounced improvements in oxidative stress markers, immune function, and recovery.
- Conclusions
Addressing selenium deficiency through personalized therapeutic strategies is critically important in trauma and intensive care settings. Further large-scale trials are essential to optimize dosing regimens, refine combination nutrient therapies, and definitively validate selenium’s clinical efficacy in critical care management.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11939285/