A Cochrane review [Abstract] 1 included seven studies on the effects of selenium supplementation (including ebselen), on adults recovering from critical illness, with a total of 813 subjects. The trials were small, the study quality was poor, and the availability of outcome data was limited.
Four selenium trials showed no statistically significant difference in mortality (relative risk (RR) 0.52, 95% confidence interval (CI) 0.20 to 1.34; random effects model). Three trials of ebselen also showed no statistically significant difference in mortality (RR 0.83, 95% CI 0.51 to 1.35). One trial of selenium found no statistically significant difference between groups for participants developing infection (RR 1.33, 95% CI 0.55 to 3.24). Three trials of ebselen provided data for participants developing infections (pyrexia, respiratory infections or meningitis), which was not statistically significant (RR 0.60, 95% CI 0.36 to 1.02). No clear evidence emerged for the benefits of selenium or ebselen supplementation for the outcomes of days on a ventilator, length of intensive care unit stay, length of hospital stay or quality of life.
Comment: The quality of evidence is downgraded by imprecise results (few patients and wide confidence intervals), by indirectness (clinically important outcomes not reported) and by limitations in study quality (inadequate reporting).
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