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

J Cardiothorac Surg. 2024 Apr 24;19(1):264. doi: 10.1186/s13019-024-02761-4.

Abstract

Introduction: 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.

Methods: 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).

Results: 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.

Conclusion: 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.

Keywords: Acute kidney injury; Cardiac surgery; Meta-analysis; Selenium.

Publication types

  • Meta-Analysis
  • Systematic Review

MeSH terms

  • Cardiac Surgical Procedures* / adverse effects
  • Dietary Supplements
  • Humans
  • Length of Stay / statistics & numerical data
  • Postoperative Complications* / epidemiology
  • Postoperative Complications* / prevention & control
  • Randomized Controlled Trials as Topic
  • Selenium* / administration & dosage
  • Selenium* / therapeutic use

Substances

  • Selenium