Trauma patients benefit from early intervention with selenium

Both physical traumas and critical illnesses are associated with inflammation and oxidative stress where free radicals can cause potentially life-threatening damage to cells and tissues. Traumas are estimated to be the cause of one in ten deaths. New research suggests that early intervention with selenium may shorten the hospital stay including the days spent in intensive care and reduce total mortality. This was shown in a study published in Frontiers in Nutrition where the researchers looked closer at selenium’s unique antioxidant properties and anti-inflammatory effect.

Physical trauma that requires fast and intensive care includes lesions, blood clots, stroke, severe burns, and serious infections. Sepsis, acute respiratory distress syndrome (ARDS), and other types of organ failure account for one in ten deaths.
If death occurs within days or weeks of the trauma, it is associated with derailed inflammatory processes. Under normal conditions, inflammation is the body’s natural response to cell damage and infection, and the process involves the production of free radicals. However, the body should always control and terminate these inflammatory processes after a short while in order to avoid oxidative stress and cell damage caused by too many free radicals. Blood poisoning and complicated cases of influenza and COVID-19 are associated with hyperinflammation that can become potentially life-threatening.
It is a known fact that micronutrients like selenium contribute to the body’s immune defense and antioxidant defense and that selenium levels in plasma in connection with critical disease are low. Therefore, the scientists behind the news study wanted to see if fast intervention with selenium could have a positive effect on trauma patients.
The study included 20 eligible trauma patients who had just been admitted to intensive care. The participants or their next of kin gave written consent to the use of selenium therapy. There were certain exclusion criteria such as death in the emergency room, being moved between hospitals, or being under the age of 18.
As soon as the selected patients were admitted to intensive care, they were treated with 100 micrograms of intravenous selenium three times daily for five days in combination with other types of acute therapy. The scientists then looked at patient survival, length of stay in the hospital/intensive care unit, serum changes, time spent in a ventilator, and respiratory function. Compared with the control group, the group that received selenium had the following advantages:

• Significantly shorter hospital stay
• Significantly less time spent in intensive care
• Improvement of neutrophilic granulocytes (white blood cells), liver function, and CRP (C-reactive protein). CRP is a marker of inflammation
• Improved body control of inflammatory processes
• Faster healing of damaged organs, especially the liver
• Improved survival rate

Selenium plays several vital roles in trauma and in other critical illnesses

Selenium is a trace element that is involved 25-30 different selenium-dependent proteins, including various enzymes and antioxidants. The reason that the selenium concentration in plasma is extremely low following the first 6-12 hours of a trauma is that selenium is incorporated in white blood cells. The researchers mention how selenium helps regulate the inflammatory processes by way of different mechanisms. Selenium also serves as an important antioxidant (GPx) that protects cell and tissues against oxidative stress.
It is known that traumas and critical illness such as blood poisoning are linked to oxidative stress and systemic inflammatory response syndrome (SIRS) that can cause damage to the endothelial cells in blood vessels and lungs, ARDS (acute respiratory distress syndrome), and organ failure. Numerous studies have shown that systemic inflammatory processes develop during the initial phase of a trauma. It is therefore vital that the inflammatory processes are executed and run smoothly and are terminated during the second phase to avoid life-threatening damage.
It is also known that chronic low-grade inflammation sets the stage for a number of chronic diseases such as atherosclerosis, cancer, autoimmune diseases, and neurological disorders. Lack of selenium and other antioxidants generally appear to worsen the prognosis.
The new study of trauma patients supports earlier studies. As examples, the scientists mention six previously published controlled, randomized studies where early therapy with selenium (200-500 micrograms daily) given to critically ill patients had a positive effect. No adverse effects were observed.
It is generally advisable to get plenty of selenium on a daily basis to ensure proper selenium saturation of all the vital selenoproteins.

• Selenium plays a vital role during the initial inflammatory phase
• Selen also plays an important role during the next phase where the inflammatory processes must be terminated
• Selenium is also crucial for the important GPX antioxidants
• Lack of selenium increases the risk of oxidative stress and leaves your more vulnerable if you suffer from trauma or critical illness

Sources:

Yu-Cheng Chiu et al. The influence of early selenium supplementation on trauma patients: A propensity-matched analysis. Frontiers in Nutrition. 08 December 2022