Substitution of selenium in children with SIRS

Patients and Method: At the Clinic for Paediatric Surgery of the University of Dresden, in a time period ranging from 5/1994 to 12/1996, all patients aged between 1 and 16 years with severe inflammatory surgical diseases or e xtended scalded skin, were given an adjuvant selenium substitution. As cont rol group, all patients with the same diagnosis and age treated during the months 1/1997 to 12/1998, did not receive this adjuvant selenium substituti on All these patients fulfilled the criteria of "Systemic Inflammatory Resp onse Syndrome" (SIRS). The selenium-therapy group consisted of 34 patients and the control group without substitution consisted of 31 patients. The fo llowing laboratory parameter; were measured on the 1st, 2nd, 3rd, 6th and l ast treatment day: white blood cell count, interleukin, C-reactive protein, fibrinogen, malondialdehyde, activity of glutathione peroxidase in plasma and level of selenium in plasma and whole blood. Results: The initially high interleukin 6 rates declined significantly in b oth groups from the 2nd day on. The acute phase proteins, i.e, the C-reacti ve protein and fibrinogen, normalized in both groups after the 3rd day of t reatment. The initial low rates of selenium in plasma and blood gained more rapidly a normal level in the therapy group than in the control group. On the ist day of therapy the glutathione peroxidase activity in plasma was in both groups at the inferior limit of norm range and remained at this level in the control group for the whole observation period. ill the selenium-su bstitution group on the contrary, these initial low values raised to the do uble as an expression of an elevated cell membrane protection. The initial significant elevated malondialdehyde rates in both groups, expressing a rai sed lipidperoxidation, fell down to a normal level in the selenium-substitu tion group, whereas they remained at their initial high level in the contro l group during the whole observation period. Conclusion: The substitution of selenium in children with SIRS is a support ive therapy.