Selenium!
Interesting article published this month in CCM Journal regarding role of trace elements selenium, copper, and zinc in cardiac surgery.
Study was done with background that the trace elements selenium, copper, and zinc are essential for maintaining the oxidative balance. A depletion of antioxidative trace in critically ill patients is associated with the development of multiorgan dysfunction. Cardiac surgery using cardiopulmonary bypass provokes ischemia-reperfusion-mediated oxidative stress. Authors hypothesized that an intraoperative decrease of circulating trace elements may be involved in this response.
This observational study was done on 60 patients undergoing cardiac surgery with cardiopulmonary bypass.
Selenium, copper, and zinc were measured after induction of anesthesia and 1 hr after admission to the intensive care unit. All patients were separated in a priori defined subgroups according to the development of no organ failure, single organ failure, and more than/= 2 organ failures in the postoperative period.
In all patients, blood levels of selenium, copper, and zinc were significantly reduced after end of surgery. During their intensive care unit stay, 17 patients were free from any organ failure, while 31 patients developed single-organ failure and 12 patients multiple organ failure.
Multilogistic regression analysis showed that selenium concentrations at end of surgery were independently associated with the postoperative occurrence of multiorgan failure.
Authors concluded that cardiac surgery using cardiopulmonary bypass resulted in a profound intraoperative decrease of whole blood levels of antioxidant trace elements. Low selenium concentrations at end of surgery were an independent predictor for the postoperative development of multiorgan failure.
The intraoperative decrease of selenium is associated with the postoperative development of multiorgan dysfunction in cardiac surgical patients - Stoppe, Christian; Schälte, Gereon; Rossaint, Rolf; Coburn, Mark; Graf, Beatrix; Spillner, Jan; Marx, Gernot; Rex, Steffen, Critical Care Medicine. 39(8):1879-1885, August 2011.
