Table 2 The effect of selenium therapy in critically ill patients
Outcomes | Comparison (s) | Number of trials | Number of participants (intervention/control) | Follow-up (range), wk | Dose (range) µg/day | Effect size (95%CI) | Absolute effect (95% CI) | P-value | I2 (%) | Pheterogeneity | Egger’s test | Certainty of evidence (GRADE) |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
Mortality (regardless of period of time) | Placebo, no treatment, standard care and low dose of selenium | 16 | 2324 (1161/1163) | 1–52 | 30–4000 | RR, 0.83 (0.71, 0.98) | 14 lower (24 lower to 3 lower) | 0.024 | 31.6 | 0.110 | 0.036 | Low |
Mortality by duration (28 days) | Placebo, no treatment, standard care, normal saline and low dose of selenium | 21 | 3714 (1839/1875) | 1–52 | 30–4000 | RR, 0.95 (0.82, 1.09) | 10 lower (16 lower to 4 lower) | 0.478 | 21.1 | 0.189 | 0.476 | Moderate |
Risk of acute renal failure | Placebo, standard care, low dose of selenium | 8 | 700 (359/341) | 1.5–2 | 30–4000 | RR, 0.67 (0.46, 0.98) | 5 lower (10 lower to 0) | 0.038 | 0.0 | 0.659 | 0.180 | Low |
Adverse events | Placebo and low dose of selenium | 7 | 2014 (1002/ 1012) | 1–3 | 30–4000 | RR, 0.98 (0.88, 1.10) | 51 lower (79 lower to 23 lower) | 0.788 | 26.4 | 0.227 | 0.761 | Moderate |
Risk of infection | Placebo, normal saline and low dose of selenium | 9 | 2083 (1037/1046) | 2–52 | 300–4000 | RR, 0.92 (0.80, 1.05) | 0.0 (3 lower to 4 upper) | 0.207 | 0.0 | 0.620 | 0.673 | Moderate |
Risk of pneumonia | Placebo | 3 | 280 (138/142) | 4–52 | 1000–4000 | RR, 1.11 (0.72, 1.72) | 3 lower (17 lower to 11 uppers) | 0.625 | 5.1 | 0.349 | 0.117 | Low |
Length of ICU stay | Placebo, no treatment, standard care, low dose of selenium | 13 | 2928 (1431/1497) | 2–52 | 30–4000 | MD, 0.15 (− 1.75, 2.05) | – | 0.876 | 95.8 | < 0.001 | 0.850 | Very low |
Length of hospital stay | Placebo, no treatment, normal saline standard care, low dose of selenium | 9 | 1597 (774/823) | 2–52 | 35–3000 | MD, − 0.51 (− 3.74, 2.72) | – | 0.757 | 96.0 | < 0.001 | 0.428 | Very low |
Days on ventilation | Placebo, normal saline standard care, low dose of selenium | 8 | 429 (216/213) | 3–52 | 35–4000 | MD, − 0.98 (− 2.93, 0.98) | – | 0.329 | 76.4 | < 0.001 | 0.186 | Very low |