The Prognostic Impact of Selenium On Critical Surgical Patients
Selenium is an important trace element for human for its multiple roles such as the antioxidant activity. Previous evidences showed that critically ill patients may benefit from selenium supplement but the dose and results are controversial.
Patients after operations for acute abdomen usually suffer from sepsis and stress. The aim of this study is to investigate the efficacy of selenium replacement in critical patients of acute abdomen, to see the impact on prognosis.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Detailed Description
Acute abdomen is a common surgical emergency and is often the result of peritonitis due to an acute inflammatory process within abdominal cavity. Many of the patients with acute abdomen have severe sepsis and are critically ill that require an emergency surgery.
The mortality rate of such patients are high because these patients usually have a profound pathophysiological dysregulation and multiple organ dysfunction. One of the mechanism of is the loss of anti-oxidative capacity of cells that fail to recover from ischemic-reperfusion injury.
Selenium is an important cofactor that participate in the antioxidant activity of glutathione peroxidase reaction. There are evidences that critically ill patients may benefit from selenium supplement by better outcome and less mortality but the dose and results are still heterogenous and inconclusive.
The aim of this study is to investigate the efficacy of selenium replacement in critical patients of acute abdomen, to see if there is a significant impact on prognosis, and to establish a clinical guide in the future.
Study Type
Study Type
Enrollment (Actual)
Enrollment
Phase
Phase
- Phase 4
Contacts and Locations
Study Locations
-
-
-
Taoyuan, Taiwan, 333
- Chang Gung Memorial Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
Accepts Healthy Volunteers
Genders Eligible for Study
Description
Inclusion Criteria:
- Intensive care unit (ICU) patients receiving abdominal surgeries for acute abdomen
- within 48 hours post-operatively
- stay in ICU for more than 48 hours
- meets sepsis criteria of Sepsis-3 (2016)
Exclusion Criteria:
- liver cirrhosis Child-Pugh score B or C
- breastfeeding or pregnancy
- allergy yo selenium
- vegetative status or irreversible diseases with life-expectancy fewer than 28 days
- End-stage renal disease under dialysis
- Human immunodeficiency virus infection
- neutropenia not due to sepsis (granulocyte < 1000/mm3)
- Heart failure (New York Heart Association class III-IV) or recent myocardial infarction (within 6 weeks)
- post cardiopulmonary cerebral resuscitation within 4 weeks
- taking immunosuppressants
- receiving anti-cancer therapy
- signed do not resuscitation
- joined other clinical research
Study Plan
How is the study designed?
Design Details
- Primary Purpose: TREATMENT
- Allocation: RANDOMIZED
- Interventional Model: PARALLEL
- Masking: SINGLE
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
EXPERIMENTAL: low serum selenium with selenium supplement
Patients having low serum selenium with selenium supplement given
|
Zelnite 400mcg/day in normal saline 100ml iv infusion for 7 days
Other Names:
|
|
PLACEBO_COMPARATOR: low serum selenium with placebo supplement
Patients having low serum selenium with placebo given
|
normal saline 100ml iv infusion for 7 days
|
|
ACTIVE_COMPARATOR: non-low serum selenium with selenium supplement
Patients having normal serum selenium with selenium supplement given
|
Zelnite 400mcg/day in normal saline 100ml iv infusion for 7 days
Other Names:
|
|
PLACEBO_COMPARATOR: non-low serum selenium with placebo supplement
Patients having normal serum selenium with placebo given
|
normal saline 100ml iv infusion for 7 days
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
mortality rate
Time Frame: 30 day
|
mortality rate in 30 days
|
30 day
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
hospital length
Time Frame: 1 year
|
hospital length for current admission
|
1 year
|
|
ventilator length
Time Frame: 1 year
|
ventilator length for current admission
|
1 year
|
|
complication rate
Time Frame: 30 days
|
complication rate within 30 days
|
30 days
|
|
organ failure rate
Time Frame: 30 days
|
organ failure rate within 30 days
|
30 days
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Principal Investigator: Yu-Tung Wu, MD, Chang Gung Memorial Hospital
Publications and helpful links
General Publications
- Singer P, Blaser AR, Berger MM, Alhazzani W, Calder PC, Casaer MP, Hiesmayr M, Mayer K, Montejo JC, Pichard C, Preiser JC, van Zanten ARH, Oczkowski S, Szczeklik W, Bischoff SC. ESPEN guideline on clinical nutrition in the intensive care unit. Clin Nutr. 2019 Feb;38(1):48-79. doi: 10.1016/j.clnu.2018.08.037. Epub 2018 Sep 29.
- Allingstrup M, Afshari A. Selenium supplementation for critically ill adults. Cochrane Database Syst Rev. 2015 Jul 27;2015(7):CD003703. doi: 10.1002/14651858.CD003703.pub3.
Study record dates
Study Major Dates
Study Start (ACTUAL)
Study Start
Primary Completion (ACTUAL)
Primary Completion
Study Completion (ACTUAL)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (ACTUAL)
First Posted
Study Record Updates
Last Update Posted (ACTUAL)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- 201902287A3A0
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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