• Journal of critical care · Oct 2024

    Randomized Controlled Trial

    The effect of high-dose selenium on mortality and postoperative organ dysfunction in post-cardiotomy cardiogenic shock patients supported with mechanical circulatory support - A post-hoc analysis of the SUSTAIN CSX trial.

    • Sascha Ott, Ellen Dresen, Zheng Yii Lee, Lukas M Müller-Wirtz, Livia Procopiuc, Elyad Ekrami, Leonard Pitts, Nicolas Hellner, Daniel Catena, Georg Daniel Duerr, Maria Wittmann, Reiner M Waeschle, Gunnar Elke, Benjamin O'Brien, Daren K Heyland, and Christian Stoppe.
    • Deutsches Herzzentrum der Charité, Department of Cardiac Anaesthesiology and Intensive Care Medicine, Berlin, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Germany; DZHK (German Centre for Cardiovascular Research), Partner Site Berlin, Berlin, Germany; Outcomes Research Consortium, Department of Anesthesiology, Cleveland Clinic, OH, USA. Electronic address: Sascha.ott@dhzc-charite.de.
    • J Crit Care. 2024 Oct 1; 83: 154853154853.

    PurposeCardiac surgery, post-cardiotomy cardiogenic shock (PCCS), and temporary mechanical circulatory support (tMCS) provoke substantial inflammation. We therefore investigated whether a selenium-based, anti-inflammatory strategy would benefit PCCS patients treated with tMCS in a post-hoc analysis of the sustain CSX trial.MethodsPost-hoc analysis of patients receiving tMCS for PCCS in the Sustain CSX trial, which investigated the effects of high-dose selenium on postoperative organ dysfunction in cardiac surgery patients.Primary Outcomeduration of tMCS therapy.Secondary Outcomespostoperative organ dysfunction and 30-day mortality.ResultsThirty-nine patients were treated with tMCS for PCCS. There was no difference in the median duration of tMCS between the selenium and the placebo group (3 days [IQR: 1-6] vs. 2 days [IQR: 1-7], p = 0.52). Median dialysis duration was longer in the selenium group (1.5 days [0-21.8] vs. 0 days [0-1.8], p = 0.048). There was no difference in 30-day mortality (53% vs. 41%, OR 1.44, 95% CI 0.32-6.47, p = 0.62).ConclusionIn this explorative study, a perioperative high-dose selenium-supplementation did not show beneficial effects on organ dysfunctions and mortality rates in patients with PCCS receiving tMCS.Copyright © 2023. Published by Elsevier Inc.

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