The Effectiveness of Selenium in Oral Nutritional Therapy for Patients With Subarachnoid Hemorrhage

S. Z. Faritous, Zohre Hashemi, M. Hajiesmaeili, Zohreh Morshedizad, H. Bakhshandeh, Soha Mehrabimahani
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Abstract

Background and Aim: Every year, traumatic brain injuries lead to more than one million admissions to emergency rooms and more than 50,000 deaths, and millions of disabilities worldwide, among all ages and genders. This study aimed to examine the effects of selenium added to oral nutritional therapy on the mortality rate and length of hospital stay in patients with subarachnoid hemorrhage admitted to the intensive care unit (ICU) for six months. Methods and Materials/Patients: This clinical trial included 100 patients admitted to the ICU of Loghman Hakim Hospital, Tehran, Iran. These patients were then randomly assigned to intervention or control groups. Standard oral solutions were administered to both groups according to recommended guidelines. Along with the standard nutritional intake, the participants in the intervention group were given 1000 μg of selenium (Selenase-Biosyn, Germany) on the first day of feeding, dissolved in 100 mL of normal saline for 30 minutes, followed by 500μg of selenium daily for 10 days. We screened patients for GCS, and APACHE-II scores, as well as cortisol levels on days 1 and 10. Results: The APACHE-II mean score on the 10th day was significantly different between the two groups, and this was also true before the intervention. In terms of mortality rates, there was no significant difference between the control group and the intervention group. Neither the control group nor the intervention group spent significantly more time in ICU. Conclusion: The effects of selenium on other variables were unclear, although mortality rates did not differ significantly between the two groups. Considering the confounding variables through regression analysis, the APACHE-II variable was negatively impacted by selenium, but taking into account the significant effect of age, a definitive conclusion cannot be made.
硒在蛛网膜下腔出血患者口服营养治疗中的疗效观察
背景和目的:每年,世界各地所有年龄和性别的创伤性脑损伤导致100多万人进入急诊室,5万多人死亡,数百万人残疾。本研究旨在探讨口服营养治疗中添加硒对重症监护病房(ICU) 6个月蛛网膜下腔出血患者死亡率和住院时间的影响。方法和材料/患者:本临床试验纳入伊朗德黑兰Loghman Hakim医院ICU收治的100例患者。然后将这些患者随机分配到干预组或对照组。两组均按推荐指南给予标准口服溶液。在标准营养摄入的同时,干预组在饲喂第一天给予硒(Selenase-Biosyn,德国)1000 μg,溶解于100 mL生理盐水中30分钟,随后每天给予硒500μg,连续10天。我们在第1天和第10天筛选患者的GCS、APACHE-II评分以及皮质醇水平。结果:两组治疗第10天APACHE-II平均评分差异有统计学意义,干预前亦是如此。在死亡率方面,对照组和干预组之间没有显著差异。对照组和干预组在ICU的时间都没有明显增加。结论:硒对其他变量的影响尚不清楚,尽管两组之间的死亡率没有显着差异。通过回归分析,考虑混杂变量,APACHE-II变量受到硒的负向影响,但考虑到年龄的显著影响,无法得出明确的结论。
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