BLOOD SELENIUM CONCENTRATIONS IN SEPTIC SHOCK DUE TO PERITONITIS

Introduction: Decreased plasma selenium concentrations may occur in Intensive Care Unit (ICU) patients with a systemic inflammatory response. The decrease may be related to a three-fold increase in morbidity and mortality (1). Supplementation of selenium may represent a simple and valuable therapeutic intervention in critically ill patients (2). To further explore this issue, we investigated blood selenium concentrations in a clinically relevant sheep model of septic shock. Methods: Six female (BW: 27.5 ± 2.5 Kg) anesthetized, mechanically ventilated, hemodynamically monitored sheep received 1.5 g/kg body weight feces intraperitoneally to induce sepsis. Ringer's lactate and 6% hydroxyethyl starch solutions were infused throughout the experiment to prevent hypovolemia. No antibiotics or vasoactive agents were used. All animals were studied until spontaneous death. Plasma selenium was analyzed by Inductively Coupled Plasma Sector Field Mass Spectrometry (ICP-SFMS) method. The normal range of selenium in sheep is 67.4 ± 1.82 μg/L (3). Result: All animals developed a hyperdynamic phase characterized by hypotension, increased cardiac index and decreased systemic vascular resistance. All had metabolic acidosis with hyperlactatemia. Blood selenium concentrations decreased to 50% six hours after feces injection (P < 0.05). All animals died of multi-organ failure with respiratory failure, oliguria and anuria. The mean survival time was 18.6 ± 2.5 hours. Conclusion: In this clinically relevant septic shock model, the blood selenium concentration fell already within the few hours following the onset of fecal peritonitis.Figure