Objective: Existing data indicate that selenium supplementation may be
beneficial in critically ill patients and in those with ischemic stroke.
The purpose of this retrospective study was to explore the influence of
early administration of selenium on neurological outcome after
cardiopulmonary resuscitation (CPR).
Methods: We examined 227 consecutive unconscious patients after CPR and
excluded 1 individual. The decision to administer selenium was left to
the discretion of the attending physician, resulting in 124 patients
(55%) who received intravenous selenium (200-1000 mu g/d) for a median
of 5 days after CPR. Patients were classified according to the best
Glasgow-Pittsburgh cerebral performance categories (CPCs 1-5) achieved
within 6 months of follow-up.
Results: The rate of regaining consciousness (CPC 1-3) after CPR was
58%. Multivariable logistic regression analysis confirmed a shockable
first monitored rhythm (adjusted odds ratio, 3.73; 95% confidence
interval, 1.85-7.52; P < .001), time to return of spontaneous
circulation (adjusted odds ratio, 0.94; 95% confidence interval,
0.91-0.96; P < .001), administration of selenium (adjusted odds ratio,
2.38; 95% confidence interval, 1.19-4.76; P = .014), and the Simplified
Acute Physiology Score II (adjusted odds ratio, 0.96; 95% confidence
interval, 0.93-0.99; P = .034) as independent predictors of regaining
consciousness after CPR. Survival at 6 months of follow-up was not
improved significantly by selenium.
Conclusion: This retrospective analysis leads to the hypothesis that
early administration of selenium may improve neurological outcome after
cardiac arrest. (C) 2009 Elsevier Inc. All rights reserved.
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