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Intensive Care Medicine

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01-03-2005 | Systematic Review

Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient

Authors: Daren K. Heyland, Rupinder Dhaliwal, Ulrich Suchner, Mette M. Berger

Published in: Intensive Care Medicine | Issue 3/2005

Abstract

Objective

Critical illness is associated with the generation of oxygen free radicals and low endogenous antioxidant capacity leading to a condition of oxidative stress. We investigated whether supplementing critically ill patients with antioxidants, trace elements, and vitamins improves their survival.

Methods

We searched four bibliographic databases from 1980 to 2003 and included studies that were randomized, reported clinically important endpoints in critically ill patients, and compared various trace elements and vitamins to placebo.

Results

Eleven articles met the inclusion criteria. When the results of all the trials were aggregated, overall antioxidants were associated with a significant reduction in mortality [Risk Ratio (RR) 0.65, 95% confidence intervals (CI) 0.44–0.97, p=0.03] but had no effect on infectious complications. Studies that utilized a single trace element were associated with a significant reduction in mortality [RR 0.52, 95% CI 0.27–0.98, p=0.04] whereas combined antioxidants had no effect. Studies using parenteral antioxidants were associated with a significant reduction in mortality [RR 0.56, 95% CI 0.34–0,92, p=0.02] whereas studies of enteral antioxidants were not. Selenium supplementation (alone and in combination with other antioxidants) may be associated with a reduction in mortality [RR 0.59, 95% CI 0.32–1.08, p=0.09] while nonselenium antioxidants had no effect on mortality.

Conclusions

Trace elements and vitamins that support antioxidant function, particularly high-dose parenteral selenium either alone or in combination with other antioxidants, are safe and may be associated with a reduction in mortality in critically ill patients.

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Title: Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient
Authors: Daren K. Heyland
Rupinder Dhaliwal
Ulrich Suchner
Mette M. Berger
Publication date: 01-03-2005
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 3/2005
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-004-2522-z

At a glance: The STEP trials

Springer Medicine

Antioxidant nutrients: a systematic review of trace elements and vitamins in the critically ill patient

Abstract

Objective

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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