Efficacy of selenium on patients undergoing cardiac surgery: a meta-analysis of randomized controlled trials

• Published in: Journal of cardiothoracic surgery Vol. 19; no. 1; p. 264
• Main Authors: Sarhan, Ahmed M, Awad, Ahmed K, Alassiri, Abdullah K, Abd-Alkhaleq, Mohamed Sameh, Al-Asmar, Rahmeh, Gonnah, Ahmed Reda
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 24-04-2024; BioMed Central; BMC
• Subjects: Acute kidney injury; Analysis; Anti-inflammatory agents; Antioxidants; Bias; C-reactive protein; Cardiac patients; Cardiac surgery; Cardiac Surgical Procedures - adverse effects; Clinical trials; Complications; Complications and side effects; Coronary vessels; Dietary Supplements; Heart; Heart surgery; Hospitals; Humans; Inflammation; Inflammatory response; Intervention; Kidneys; Length of Stay - statistics & numerical data; Meta-analysis; Mortality; Nosocomial infections; Patients; Postoperative; Postoperative Complications - epidemiology; Postoperative Complications - prevention & control; Randomized Controlled Trials as Topic; Review; Selenium; Selenium - administration & dosage; Selenium - therapeutic use; Supplements; Surgery; Systematic review; Cardiac surgery; Selenium; Acute kidney injury; Meta-analysis
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-024-02761-4

Postoperative complications pose significant challenges in cardiac surgery and with the evolution of selenium as a potential anti-inflammatory agent, some studies reported its inefficiency. Thus, we conducted our meta-analysis to evaluate the impact of selenium supplementation on cardiac surgery patients.
Different databases such as PubMed, Embase, and Cochrane Library from inception till January 2024 were searched identifying a total of seven randomized-controlled trials involving selenium supplementation after cardiac surgery. Risk ratio (RR) and Mean difference (MD) were calculated with a 95% confidence interval (CI).
The selenium intervention significantly raised the incidence of Acute Kidney injury (RR 0.76; 95% CI: 0.59, 0.98; P = 0.04) while significantly reducing the duration of hospital stay (MD -1.33; 95% CI: -2.51, -0.16; P = 0.03) and postoperative CRP levels (SMD -0.18; 95% CI: -0.34, -0.02; P = 0.03). The effect of selenium intervention on days spent in ICU (MD -0.01; 95% CI: -0.28, 0.25; P = 0.92), mortality (RR 1.07; 95% CI: 0.84, 1.37; P = 0.57) and incidence of hospital acquired infections (RR 0.98; 95% CI: 0.76, 1.26; P = 0.88) is insignificant.
Selenium supplementation did not significantly reduce major postoperative complications in cardiac surgery patients. However, its ability to modulate inflammation, as reflected in decreased C-reactive protein levels, highlights its potential role in managing the inflammatory response. Future investigations should focus on optimized selenium supplementation strategies in conjunction with other antioxidants to enhance its benefits.